Oral health care utilization by US rural residents, National Health Interview Survey 1999.

PubMed

Vargas, Clemencia M; Dye, Bruce A; Hayes, Kathy

2003-01-01

To compare the dental care utilization practices of rural and urban residents in the United States. Data on dental care utilization from the 1999 National Health Interview Survey for persons 2 years of age and older (n=42, 139) were analyzed by rural/urban status. Percentages and 95 percent confidence intervals were calculated to produce national estimates for having had a visit in the past year, the number of visits, reasons given for last dental visit and for not visiting a dentist, unmet dental needs, and private dental insurance. Rural residents were more likely to report that their last dental visit was because something was "bothering or hurting" (23.3% vs 17.6%) and that they had unmet dental needs (10.1% vs 7.5%). Urban residents were more likely to report having a dental visit in the past year (57.7% vs 66.5%) and having private dental insurance (32.7% vs 37.2%), compared to rural residents. There were no significant differences in most reasons given for not visiting the dentist between rural and urban respondents. Dental care utilization characteristics differ between rural and urban residents in the United States, with rural residents tending to underutilize dental care.

7 CFR 2003.10 - Rural Development State Offices.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Multi-Family Housing loans and grants, Community Facility, Water and Waste Disposal, Business and... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... accounting purposes, are housed in the RHS agency. (b) Program Directors within the State Office provide...

Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

PubMed

Whitehead, J; Shaver, John; Stephenson, Rob

2016-01-01

Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

Utilization characteristics and importance of woody biomass resources on the rural-urban fringe in botswana.

PubMed

Nkambwe, Musisi; Sekhwela, Mogodisheng B M

2006-02-01

This article examines the utilization characteristics and importance of woody biomass resources in the rural-urban fringe zones of Botswana. In the literature for Africa, attention has been given to the availability and utilization of biomass in either urban or rural environments, but the rural-urban fringe has been neglected. Within southern Africa, this neglect is not justified; the rural-urban fringe, not getting the full benefits available in urban environments in Botswana, has developed problems in woody biomass availability and utilization that require close attention. In this article, socioeconomic data on the importance of woody biomass in the Batlokwa Tribal Territory, on the rural-urban fringe of Gaborone, Botswana, were collected together with ecologic data that reveal the utilization characteristics and potential for regrowth of woody biomass. The analysis of these results show that local woody biomass is very important in the daily lives of communities in the rural-urban fringe zones and that there is a high level of harvesting. However, there is no effort in planning land use in the tribal territory to either conserve this resource or provide alternatives to its utilization. The future of woody biomass resources in Botswana's rural-urban fringe is uncertain. The investigators recommend that a comprehensive policy for the development of the rural-urban fringe consider the importance of this resource. The neglect of this resource will have far-reaching implications on the livelihoods of residents as well as the environment in this zone.

Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations

PubMed Central

Whitehead, J.; Shaver, John; Stephenson, Rob

2016-01-01

Background Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. Methodology LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and “outness,” and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals’ demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Results Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. Conclusions The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients’ disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas. PMID:26731405

7 CFR 1794.54 - Agency determination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Agency determination. 1794.54 Section 1794.54 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Procedure for Environmental Assessments With...

7 CFR 1794.54 - Agency determination.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Agency determination. 1794.54 Section 1794.54 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Procedure for Environmental Assessments With...

7 CFR 1794.54 - Agency determination.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Agency determination. 1794.54 Section 1794.54 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Procedure for Environmental Assessments With...

7 CFR 1794.54 - Agency determination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Agency determination. 1794.54 Section 1794.54 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Procedure for Environmental Assessments With...

7 CFR 1794.54 - Agency determination.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Agency determination. 1794.54 Section 1794.54 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Procedure for Environmental Assessments With...

7 CFR 1955.144 - Disposal of NP or surplus property to, through, or acquisition from other agencies.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED... chattel property cannot be sold (or only token offers are received for it), the appropriate Assistant...

7 CFR 1955.144 - Disposal of NP or surplus property to, through, or acquisition from other agencies.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED... chattel property cannot be sold (or only token offers are received for it), the appropriate Assistant...

7 CFR 1955.144 - Disposal of NP or surplus property to, through, or acquisition from other agencies.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED... chattel property cannot be sold (or only token offers are received for it), the appropriate Assistant...

Determinants of Maternity Care Services Utilization among Married Adolescents in Rural India

PubMed Central

Singh, Prashant Kumar; Rai, Rajesh Kumar; Alagarajan, Manoj; Singh, Lucky

2012-01-01

Background Coupled with the largest number of maternal deaths, adolescent pregnancy in India has received paramount importance due to early age at marriage and low contraceptive use. The factors associated with the utilization of maternal healthcare services among married adolescents in rural India are poorly discussed. Methodology/Principal Findings Using the data from third wave of National Family Health Survey (2005–06), available in public domain for the use by researchers, this paper examines the factors associated with the utilization of maternal healthcare services among married adolescent women (aged 15–19 years) in rural India. Three components of maternal healthcare service utilization were measured: full antenatal care, safe delivery, and postnatal care within 42 days of delivery for the women who gave births in the last five years preceding the survey. Considering the framework on causes of maternal mortality proposed by Thaddeus and Maine (1994), selected socioeconomic, demographic, and cultural factors influencing outcome events were included as the predictor variables. Bi-variate analyses including chi-square test to determine the difference in proportion, and logistic regression to understand the net effect of predictor variables on selected outcomes were applied. Findings indicate the significant differences in the use of selected maternal healthcare utilization by educational attainment, economic status and region of residence. Muslim women, and women belonged to Scheduled Castes, Scheduled Tribes, and Other Backward Classes are less likely to avail safe delivery services. Additionally, adolescent women from the southern region utilizing the highest maternal healthcare services than the other regions. Conclusions The present study documents several socioeconomic and cultural factors affecting the utilization of maternal healthcare services among rural adolescent women in India. The ongoing healthcare programs should start targeting household

7 CFR 1794.43 - Agency finding.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Agency finding. 1794.43 Section 1794.43 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... quality of the human environment, RUS will prepare a FONSI. Upon authorization of RUS, the applicant shall...

7 CFR 1794.43 - Agency finding.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Agency finding. 1794.43 Section 1794.43 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... quality of the human environment, RUS will prepare a FONSI. Upon authorization of RUS, the applicant shall...

7 CFR 1794.43 - Agency finding.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Agency finding. 1794.43 Section 1794.43 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... quality of the human environment, RUS will prepare a FONSI. Upon authorization of RUS, the applicant shall...

7 CFR 1794.43 - Agency finding.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Agency finding. 1794.43 Section 1794.43 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... quality of the human environment, RUS will prepare a FONSI. Upon authorization of RUS, the applicant shall...

7 CFR 1794.43 - Agency finding.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Agency finding. 1794.43 Section 1794.43 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... quality of the human environment, RUS will prepare a FONSI. Upon authorization of RUS, the applicant shall...

7 CFR 1794.33 - Agency action.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Agency action. 1794.33 Section 1794.33 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... action. RUS may act on an application for financial assistance upon determining, based on the review of...

7 CFR 1794.33 - Agency action.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Agency action. 1794.33 Section 1794.33 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... action. RUS may act on an application for financial assistance upon determining, based on the review of...

Gender difference in utilization willingness of institutional care among the single seniors: evidence from rural Shandong, China.

PubMed

Qian, Yangyang; Chu, Jie; Ge, Dandan; Zhang, Li; Sun, Long; Zhou, Chengchao

2017-05-12

Institutional care has become an urgent issue in rural China. Rural single seniors, compared with their counterparts, have lower income and are more vulnerable. Gender is also a significant factor determining long-term institutional care. This study is designed to examine the gender difference towards utilization willingness of institutional care among rural single seniors. A total of 505 rural single seniors were included in the analysis. Binary logistic regression model was used to examine the gender difference towards utilization willingness for institutional care, and also to identify the determinants of the utilization willingness for institutional care among rural single male and female seniors. Our study found that about 5.7% rural single seniors had willingness for institutional care in Shandong, China. Single females were found to be less willing for institutional care than single males in rural areas (OR = 0.19; 95 CI 0.06-0.57). It's also found that psychological stress was associated with institutionalization willingness in both single males (P = 0.045) and single females (P = 0.013) in rural China. The rural single seniors who lived alone were found to be more willing for institutional care both in males (P = 0.032) and females (P = 0.002) compared with those who lived with children or others. This study found that there was a gender difference towards utilization willingness for institutional care among single seniors in rural China. Factors including psychological stress and living arrangements were determinants of institutionalization willingness both in single males and females. Targeted policies should be made for rural single seniors of different gender.

Rural Health: The Story of Outreach. A Program of Cooperation in Health Care.

ERIC Educational Resources Information Center

Health Resources and Services Administration (DHHS), Rockville, MD. Office of Rural Health Policy.

Rural Health Outreach is a federal program of demonstration grants designed to encourage organizations to cooperate in delivering health care services to rural Americans. Thirteen programs utilizing innovative collaborations between state agencies, schools, nonprofit organizations, hospitals, volunteers, and the private sector are described a year…

Frustrated Freedom: The Effects of Agency and Wealth on Wellbeing in Rural Mozambique.

PubMed

Victor, Bart; Fischer, Edward; Cooil, Bruce; Vergara, Alfredo; Mukolo, Abraham; Blevins, Meridith

2013-07-01

In Sen's capability view of poverty, wellbeing is threatened by both deficits of wealth and deficits of individual agency. Sen further predicts that "unfreedom," or low levels of agency will suppress the wellbeing effects of higher levels of wealth. The current paper extends Sen's view to include a condition, labeled "frustrated freedom," in which relatively higher levels of agency can heighten the poverty effects of relatively low levels of material wealth. Applying data from a large scale population study of female heads of household in rural Mozambique, the paper empirically tests Sen's view and the proposed extension. As predicted, agency is found to moderate the relationship between agency, wealth, and wellbeing, uncovering evidence of both unfreedom and frustrated freedom in the population. Further research into the complex dynamics of wellbeing and poverty are called for by the authors.

Health insurance benefit design and healthcare utilization in northern rural China.

PubMed

Wang, Hong; Liu, Yu; Zhu, Yan; Xue, Lei; Dale, Martha; Sipsma, Heather; Bradley, Elizabeth

2012-01-01

Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS) in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care) and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful design, health insurance may not benefit those who are most in need

[Novel resources utilization technique for rural domestic refuse].

PubMed

Qiu, Cai-Di; He, Ruo; Chen, Song-Mei; Lou, Bin; Shen, Dong-Sheng

2009-03-15

In order to speed up rural domestic refuse resources utilization, intermittent aeration and continuous aeration were applied to treat rural domestic refuse after anaerobic fermentation. Three kinds of refuse were selected on base of fermentative age, i.e. three months, five months and seven months. Results showed that aeration could remove water and organic materials of the refuse effectively. Points of view on aeration, continuous aeration was better than intermittent aeration, and on the other side, water removal rate increased with ventilation and decreased with fermentative age in the condition of intermittent aeration. On organic materials removal point, it was affected by fermentative age significantly, i. e. increase of fermentative age could resulted in decrease in the removal efficiency. In conclusion, intermittent aeration of 0.06 m3/(min x m3) was considered to be feasible for treatment. The water removal efficiency of three months, five months and seven months fermentative age refuse could be up to 49.1%, 45.3% and 44.0%, and organic compound removal efficiency was 41.9%, 24.8% and 13.1%, respectively, after intermittent aeration for 21 d. Moreover, concentrated effect was presented on major nutrient ingredients, such as total nitrogen, phosphorus, and potassium during the aeration, which realized for resources utilization.

7 CFR 2003.10 - Rural Development State Offices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... to program plans approved for the State by the Under Secretary, and rendering staff advisory and... Multi-Family Housing loans and grants, Community Facility, Water and Waste Disposal, Business and...

Assessing equity of healthcare utilization in rural China: results from nationally representative surveys from 1993 to 2008

PubMed Central

2013-01-01

Background The phenomenon of inequitable healthcare utilization in rural China interests policymakers and researchers; however, the inequity has not been actually measured to present the magnitude and trend using nationally representative data. Methods Based on the National Health Service Survey (NHSS) in 1993, 1998, 2003, and 2008, the Probit model with the probability of outpatient visit and the probability of inpatient visit as the dependent variables is applied to estimate need-predicted healthcare utilization. Furthermore, need-standardized healthcare utilization is assessed through indirect standardization method. Concentration index is measured to reflect income-related inequity of healthcare utilization. Results The concentration index of need-standardized outpatient utilization is 0.0486[95% confidence interval (0.0399, 0.0574)], 0.0310[95% confidence interval (0.0229, 0.0390)], 0.0167[95% confidence interval (0.0069, 0.0264)] and −0.0108[95% confidence interval (−0.0213, -0.0004)] in 1993, 1998, 2003 and 2008, respectively. For inpatient service, the concentration index is 0.0529[95% confidence interval (0.0349, 0.0709)], 0.1543[95% confidence interval (0.1356, 0.1730)], 0.2325[95% confidence interval (0.2132, 0.2518)] and 0.1313[95% confidence interval (0.1174, 0.1451)] in 1993, 1998, 2003 and 2008, respectively. Conclusions Utilization of both outpatient and inpatient services was pro-rich in rural China with the exception of outpatient service in 2008. With the same needs for healthcare, rich rural residents utilized more healthcare service than poor rural residents. Compared to utilization of outpatient service, utilization of inpatient service was more inequitable. Inequity of utilization of outpatient service reduced gradually from 1993 to 2008; meanwhile, inequity of inpatient service utilization increased dramatically from 1993 to 2003 and decreased significantly from 2003 to 2008. Recent attempts in China to increase coverage of insurance and

Frustrated Freedom: The Effects of Agency and Wealth on Wellbeing in Rural Mozambique

PubMed Central

Victor, Bart; Fischer, Edward; Cooil, Bruce; Vergara, Alfredo; Mukolo, Abraham; Blevins, Meridith

2014-01-01

In Sen's capability view of poverty, wellbeing is threatened by both deficits of wealth and deficits of individual agency. Sen further predicts that “unfreedom,” or low levels of agency will suppress the wellbeing effects of higher levels of wealth. The current paper extends Sen's view to include a condition, labeled “frustrated freedom,” in which relatively higher levels of agency can heighten the poverty effects of relatively low levels of material wealth. Applying data from a large scale population study of female heads of household in rural Mozambique, the paper empirically tests Sen's view and the proposed extension. As predicted, agency is found to moderate the relationship between agency, wealth, and wellbeing, uncovering evidence of both unfreedom and frustrated freedom in the population. Further research into the complex dynamics of wellbeing and poverty are called for by the authors. PMID:25125791

Postacute Stroke Rehabilitation Utilization: Are There Differences between Rural-Urban Patients and Taxonomies?

ERIC Educational Resources Information Center

Jia, Huanguang; Cowper, Diane C.; Tang, Yuhong; Litt, Eric; Wilson, Lauren

2012-01-01

Purpose: To assess the association between Veterans Affairs (VA) stroke patients' poststroke rehabilitation utilization and their residential settings by using 2 common rural-urban taxonomies. Methods: This retrospective study included all VA stroke inpatients in 2001 and 2002. Rehabilitation utilization referred to rehabilitation therapy received…

Influence of health-related quality of life on health service utilization in Chinese rural-to-urban female migrant workers.

PubMed

Lu, Chu-Hong; Wang, Pei-Xi; Lei, Yi-Xiong; Luo, Zhong-Cheng

2014-08-15

Rural-to-urban migrant workers have been increasing rapidly in China over recent decades. Health related quality of life (HRQOL) may affect health service utilization. There is a lack of data on HRQOL in relation to health service utilization in Chinese rural-to-urban migrant workers. This study was aimed to explore the influence of HRQOL on health service utilization in Chinese rural-to-urban female migrant workers. This was a cross-sectional survey of 1,438 female rural-to-urban migrant workers in Shenzhen-Dongguan economic zone, China in 2013. HRQOL was assessed by the 36-items Health Survey Short Form (SF-36). Health service utilization was measured by any physician visit over the recent two weeks and any hospitalization over the last 1-year (annual hospitalization). Clustered logistic regression was used to analyze the influence of HRQOL on health service utilization. Lower scores in three HRQOL domains (bodily pain, general health, role physical) were associated with more frequent health service utilization in female rural-to-urban migrant workers. Bodily pain and general health were associated with an independent influence of 15.6% on the risk of recent two-week physician visit, while role physical and general health were associated with an independent influence of 21.2% on the risk of annual hospitalization. The independent influence of HRQOL on health service utilization was smaller than that of socio-demographic and health-related variables. HRQOL may have a modest influence on health service utilization in Chinese rural-to-urban female migrant workers - an underprivileged population in urban China.

The Rural – Urban Divide: Health Services Utilization Among Older Mexicans in Mexico

PubMed Central

Salinas, Jennifer J.; Al Snih, Soham; Markides, Kyriakos; Ray, Laura A.; Angel, Ronald J.

2010-01-01

Context Mexico Purpose Using the health care service utilization model as a framework, this paper will analyze the differences in health care service use among older Mexicans living in urban and rural areas in Mexico. Methods The Mexican Health and Aging Survey (MHAS) data were used to test the applicability of Andersen’s “model of health services” of predisposing (ie, age, sex, etc.), enabling (education, insurance coverage, etc.) and need factors (diabetes, hypertension, etc.) to predict ever being in the hospital and physician visits in the past year by place of residence (urban, rural, semi-rural). Findings Results showed that older Mexicans living in the most rural areas (populations of 2500 or fewer) were significantly less likely to have been hospitalized in the previous year and visited the physician less often (P < .0001) than their urban counterparts. The significant difference in hospitalization between rural and urban residing older Mexicans was largely accounted for by having health care coverage. Certain need factors such as diabetes, previous heart attack, hypertension, depression, and functional limitations predicted frequency of physician visits and hospitalization, but they did not explain variations between rural and urban older Mexicans. Conclusions Not having insurance coverage was associated with a lower likelihood of spending an overnight visit in the hospital and visiting a physician for older Mexicans. This lower utilization may be due to barriers to access rather than better health. PMID:21029168

41 CFR 101-26.102-2 - Utilization by military agencies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Utilization by military... SOURCES AND PROGRAM 26.1-General § 101-26.102-2 Utilization by military agencies. Military activities... the Secretary of a military department in connection with the requirements of that department, to...

Dental Service Utilization: Patterns and Barriers among Rural Elderly in Guntur District, Andhra Pradesh

PubMed Central

Koka, Krishna Mohan; Pachava, Srinivas; Sanikommu, Suresh; Ravoori, Srinivas; Chandu, Viswa Chaitanya

2016-01-01

Introduction The biological process of ageing is outside human control and has its own dynamics. It is a known fact that elderly people have more treatment needs compared to the younger population and at the same time elderly people are facing a multitude of barriers in utilization of health care as well as oral health care. Aim To identify the utilization patterns of oral health care and barriers for utilization among rural population. Materials and Methods A cross-sectional study was done on 621 rural elderly subjects to identify the utilization of oral health care services and the barriers for utilization. Using stratified cluster sampling study area was stratified into 13 rural clusters, fifty houses were randomly selected from each stratum. All the elderly subjects, as defined by the age criteria were considered for study. The data were analysed using SPSS 20 v and Chi-square tests were used to analyse the data. Results Only 31.9% of participants reported visiting a dentist in the past while 36.7% reported experiencing a dental problem at some point in their life. There were no significant differences in utilization of dental services based on gender, socio-economic status, age groups and religion. However, significant differences were found in utilization of dental services based on the response of participants to past experience of dental problems. Conclusion The present study results conclude that fear was one of the most commonly reported barriers for utilisation of dental services and there is a need for oral health education and promotion among elderly population. PMID:27135000

Health Insurance Benefit Design and Healthcare Utilization in Northern Rural China

PubMed Central

Wang, Hong; Liu, Yu; Zhu, Yan; Xue, Lei; Dale, Martha; Sipsma, Heather; Bradley, Elizabeth

2012-01-01

Background Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS) in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. Methods and Findings We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care) and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. Conclusion The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful design, health insurance

41 CFR 102-79.10 - What basic assignment and utilization of space policy governs an Executive agency?

Code of Federal Regulations, 2011 CFR

2011-01-01

... and utilization of space policy governs an Executive agency? 102-79.10 Section 102-79.10 Public... MANAGEMENT REGULATION REAL PROPERTY 79-ASSIGNMENT AND UTILIZATION OF SPACE General Provisions § 102-79.10 What basic assignment and utilization of space policy governs an Executive agency? Executive agencies...

41 CFR 102-79.10 - What basic assignment and utilization of space policy governs an Executive agency?

Code of Federal Regulations, 2012 CFR

2012-01-01

... and utilization of space policy governs an Executive agency? 102-79.10 Section 102-79.10 Public... MANAGEMENT REGULATION REAL PROPERTY 79-ASSIGNMENT AND UTILIZATION OF SPACE General Provisions § 102-79.10 What basic assignment and utilization of space policy governs an Executive agency? Executive agencies...

41 CFR 102-79.10 - What basic assignment and utilization of space policy governs an Executive agency?

Code of Federal Regulations, 2014 CFR

2014-01-01

... and utilization of space policy governs an Executive agency? 102-79.10 Section 102-79.10 Public... MANAGEMENT REGULATION REAL PROPERTY 79-ASSIGNMENT AND UTILIZATION OF SPACE General Provisions § 102-79.10 What basic assignment and utilization of space policy governs an Executive agency? Executive agencies...

41 CFR 102-79.10 - What basic assignment and utilization of space policy governs an Executive agency?

Code of Federal Regulations, 2013 CFR

2013-07-01

... and utilization of space policy governs an Executive agency? 102-79.10 Section 102-79.10 Public... MANAGEMENT REGULATION REAL PROPERTY 79-ASSIGNMENT AND UTILIZATION OF SPACE General Provisions § 102-79.10 What basic assignment and utilization of space policy governs an Executive agency? Executive agencies...

Severe situation of rural nonpoint source pollution and efficient utilization of agricultural wastes in the Three Gorges Reservoir Area.

PubMed

Zhang, Tong; Ni, Jiupai; Xie, Deti

2015-11-01

Rural nonpoint source (NPS) pollution caused by agricultural wastes has become increasingly serious in the Three Gorges Reservoir Area (TGRA), significantly affecting the reservoir water quality. The grim situation of rural NPS pollution in the TGRA indicated that agrochemicals (chemical fertilizer and pesticide) were currently the highest contributor of rural NPS pollution (50.38%). The harmless disposal rates of livestock excrement, crop straws, rural domestic refuse, and sewage also cause severe water pollution. More importantly, the backward agricultural economy and the poor environmental awareness of farmers in the hinterland of the TGRA contribute to high levels of rural NPS pollution. Over the past decade, researchers and the local people have carried out various successful studies and practices to realize the effective control of rural NPS pollution by efficiently utilizing agricultural wastes in the TGRA, including agricultural waste biogas-oriented utilization, crop straw gasification, decentralized land treatment of livestock excrement technology, and crop straw modification. These technologies have greatly increased the renewable resource utilization of agricultural wastes and improved water quality and ecological environment in the TGRA.

7 CFR 1901.507 - Certificates of beneficial ownership issued by the FmHA or its successor agency under Public Law...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Certificates of beneficial ownership issued by the FmHA or its successor agency under Public Law 103-354 Finance Office. 1901.507 Section 1901.507 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AN...

7 CFR 1901.507 - Certificates of beneficial ownership issued by the FmHA or its successor agency under Public Law...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Certificates of beneficial ownership issued by the FmHA or its successor agency under Public Law 103-354 Finance Office. 1901.507 Section 1901.507 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AN...

The Influence of Rural Location on Utilization of Formal Home Care: The Role of Medicaid

ERIC Educational Resources Information Center

McAuley, William J.; Spector, William D.; Van Nostrand, Joan; Shaffer, Tom

2004-01-01

Purpose: This research examines the impact of rural-urban residence on formal home-care utilization among older people and determines whether and how Medicaid coverage influences the association between, rural-urban location and risk of formal home-care use. Design and Methods: We combined data from the 1998 consolidated file of the Medical…

41 CFR 102-74.600 - Should Federal agencies utilize telework centers?

Code of Federal Regulations, 2011 CFR

2011-01-01

... utilize telework centers? 102-74.600 Section 102-74.600 Public Contracts and Property Management Federal... MANAGEMENT Telework § 102-74.600 Should Federal agencies utilize telework centers? Yes. In accordance with... flexiplace work telecommuting program (i.e., to pay telework center program user fees): (a) Department of...

41 CFR 102-74.600 - Should Federal agencies utilize telework centers?

Code of Federal Regulations, 2013 CFR

2013-07-01

... utilize telework centers? 102-74.600 Section 102-74.600 Public Contracts and Property Management Federal... MANAGEMENT Telework § 102-74.600 Should Federal agencies utilize telework centers? Yes. In accordance with... flexiplace work telecommuting program (i.e., to pay telework center program user fees): (a) Department of...

41 CFR 102-74.600 - Should Federal agencies utilize telework centers?

Code of Federal Regulations, 2012 CFR

2012-01-01

... utilize telework centers? 102-74.600 Section 102-74.600 Public Contracts and Property Management Federal... MANAGEMENT Telework § 102-74.600 Should Federal agencies utilize telework centers? Yes. In accordance with... flexiplace work telecommuting program (i.e., to pay telework center program user fees): (a) Department of...

41 CFR 102-74.600 - Should Federal agencies utilize telework centers?

Code of Federal Regulations, 2014 CFR

2014-01-01

... utilize telework centers? 102-74.600 Section 102-74.600 Public Contracts and Property Management Federal... MANAGEMENT Telework § 102-74.600 Should Federal agencies utilize telework centers? Yes. In accordance with... flexiplace work telecommuting program (i.e., to pay telework center program user fees): (a) Department of...

Utilization of photovoltaic for broadband satellite communications in rural area of Thailand

NASA Astrophysics Data System (ADS)

Jinayim, Theerawut; Mungkung, Narong; Kasayapanand, Nat

2013-06-01

Electricity, Information and Communication Technologies (ICTs) are very important not only in urban areas but also in rural areas. To provide ICTs service in rural areas, sources of electricity and communication infrastructures must be implemented. Electricity is a major condition due to the fact that all electronic devices needed it in order to power on, so that it is impossible to operate any forms of ICTs in areas where the main national grid line is unavailable. Almost rural areas of Thailand where the main national grid line is unavailable have very good sunlight intensity. Photovoltaic is the most effective renewable energy technologies in those areas for meeting electricity needed in areas that are not connected to the main national grid line. In this paper, the efficiency utilization of photovoltaic as source of electricity for broadband satellite communication systems as well as social and economic impact and quality of life of people in rural areas of Thailand are presented. The results show that most rural communities would be able to universally access to the basic telecommunications services such as internet access and public telephone via satellite communication systems. However, in some field case study, broadband internet access via satellite communication may be unnecessary for some rural communities and the most exactly rural communities needed are electricity for household usage and battery charger.

78 FR 33757 - Rural Determination and Financing Percentage

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-05

... supplies electricity to an electric utility serving an area that is less than 100 percent rural. By... percentage of the asset(s) can be financed, by amending 7 CFR part 1710. The properties of electricity are... territory is to be supplied with electricity by a RUS-financed project, the Agency proposes that the...

Disparities in the Utilization of Laparoscopic Surgery for Colon Cancer in Rural Nebraska: A Call for Placement and Training of Rural General Surgeons

PubMed Central

Gruber, Kelli; Soliman, Amr S.; Schmid, Kendra; Rettig, Bryan; Ryan, June; Watanabe-Galloway, Shinobu

2015-01-01

Background Advances in medical technology are changing surgical standards for colon cancer treatment. The laparoscopic colectomy is equivalent to the standard open colectomy while providing additional benefits. It is currently unknown what factors influence utilization of laparoscopic surgery in rural areas and if treatment disparities exist. The objectives of this study were to examine demographic and clinical characteristics associated with receiving laparoscopic colectomy and to examine the differences between rural and urban patients who received either procedure. Methods This study utilized a linked dataset of Nebraska Cancer Registry and hospital discharge data on colon cancer patients diagnosed and treated in the entire state of Nebraska from 2008–2011 (N=1,062). Multiple logistic regression analysis was performed to identify predictors of receiving the laparoscopic treatment. Results Rural colon cancer patients were 40% less likely to receive laparoscopic colectomy compared to urban patients. Independent predictors of receiving laparoscopic colectomy were younger age (<60), urban residence, ≥3 comorbidities, elective admission, smaller tumor size, and early stage at diagnosis. Additionally, rural patients varied demographically compared to urban patients. Conclusions Laparoscopic surgery is becoming the new standard of treatment for colon cancer and important disparities exist for rural cancer patients in accessing the specialized treatment. As cancer treatment becomes more specialized, the importance of training and placement of general surgeons in rural communities must be a priority for health care planning and professional training institutions. PMID:25951881

Utilization of Mammography Services among Elderly Rural and Urban African American Women

ERIC Educational Resources Information Center

Agho, Augustine O; Mosley, Barbara W; Rivers, Patrick A; Parker, Shandowyn

2007-01-01

Purpose: This study was a two-year educational intervention and research project aimed at increasing the awareness of breast cancer and the utilization of Clinical Breast Examination (CBE) services and Self-Breast Examination (SBE) among elderly rural and urban African American women who are Medicare beneficiaries. Design: The study was…

Husbands' involvement in delivery care utilization in rural Bangladesh: A qualitative study

PubMed Central

2012-01-01

Background A primary cause of high maternal mortality in Bangladesh is lack of access to professional delivery care. Examining the role of the family, particularly the husband, during pregnancy and childbirth is important to understanding women's access to and utilization of professional maternal health services that can prevent maternal mortality. This qualitative study examines husbands' involvement during childbirth and professional delivery care utilization in a rural sub-district of Netrokona district, Bangladesh. Methods Using purposive sampling, ten households utilizing a skilled attendant during the birth of the youngest child were selected and matched with ten households utilizing an untrained traditional birth attendant, or dhatri. Households were selected based on a set of inclusion criteria, such as approximate household income, ethnicity, and distance to the nearest hospital. Twenty semi-structured interviews were conducted in Bangla with husbands in these households in June 2010. Interviews were transcribed, translated into English, and analyzed using NVivo 9.0. Results By purposefully selecting households that differed on the type of provider utilized during delivery, common themes--high costs, poor transportation, and long distances to health facilities--were eliminated as sufficient barriers to the utilization of professional delivery care. Divergent themes, namely husbands' social support and perceived social norms, were identified as underlying factors associated with delivery care utilization. We found that husbands whose wives utilized professional delivery care provided emotional, instrumental and informational support to their wives during delivery and believed that medical intervention was necessary. By contrast, husbands whose wives utilized an untrained dhatri at home were uninvolved during delivery and believed childbirth should take place at home according to local traditions. Conclusions This study provides novel evidence about male

Providing Services for Handicapped Persons in Rural/Sparsely Populated Areas.

ERIC Educational Resources Information Center

Weatherman, Richard

The experiences of the 3-year Minnesota Severely Handicapped Delivery System Project have led to a model which utilizes resources of regional systems as key elements of a differentiated system for educational service delivery to the handicapped in rural areas and involves state education agencies, statewide regional centers, local education units,…

Rural Interagency Collaboration: A Resource Handbook for Schools and Human Service Agency Providers, Planners, and Policy Makers.

ERIC Educational Resources Information Center

Syracuse Univ., NY. School of Education.

This handbook provides information about interagency collaboration and educational partnerships in rural New York to service providers, planners, and policymakers. A survey identified 52 existing collaborative programs involving approximately 190 New York school districts and 100 nondistrict agencies and examined size and configuration of…

The Rural-Urban Divide: Health Services Utilization among Older Mexicans in Mexico

ERIC Educational Resources Information Center

Salinas, Jennifer J.; Al Snih, Soham; Markides, Kyriakos; Ray, Laura A.; Angel, Ronald J.

2010-01-01

Context: Mexico. Purpose: Using the health care service utilization model as a framework, this paper will analyze the differences in health care service use among older Mexicans living in urban and rural areas in Mexico. Methods: The Mexican Health and Aging Survey (MHAS) data were used to test the applicability of Andersen's "model of health…

The Effects of Geography and Spatial Behavior on Health Care Utilization among the Residents of a Rural Region

PubMed Central

Arcury, Thomas A; Gesler, Wilbert M; Preisser, John S; Sherman, Jill; Spencer, John; Perin, Jamie

2005-01-01

Objective This analysis determines the importance of geography and spatial behavior as predisposing and enabling factors in rural health care utilization, controlling for demographic, social, cultural, and health status factors. Data Sources A survey of 1,059 adults in 12 rural Appalachian North Carolina counties. Study Design This cross-sectional study used a three-stage sampling design stratified by county and ethnicity. Preliminary analysis of health services utilization compared weighted proportions of number of health care visits in the previous 12 months for regular check-up care, chronic care, and acute care across geographic, sociodemographic, cultural, and health variables. Multivariable logistic models identified independent correlates of health services utilization. Data Collection Methods Respondents answered standard survey questions. They located places in which they engaged health related and normal day-to-day activities; these data were entered into a geographic information system for analysis. Principal Findings Several geographic and spatial behavior factors, including having a driver's license, use of provided rides, and distance for regular care, were significantly related to health care utilization for regular check-up and chronic care in the bivariate analysis. In the multivariate model, having a driver's license and distance for regular care remained significant, as did several predisposing (age, gender, ethnicity), enabling (household income), and need (physical and mental health measures, number of conditions). Geographic measures, as predisposing and enabling factors, were related to regular check-up and chronic care, but not to acute care visits. Conclusions These results show the importance of geographic and spatial behavior factors in rural health care utilization. They also indicate continuing inequity in rural health care utilization that must be addressed in public policy. PMID:15663706

Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam

PubMed Central

2012-01-01

Introduction Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in rural health insurance system in the two countries. Methods Household survey and qualitative study were conducted in 6 counties in China and 4 districts in Vietnam. Health insurance policy and its impact on utilization of outpatient and inpatient service were analyzed and compared to measure equity in access to health care. Results In China, Health insurance membership had no significant impact on outpatient service utilization, while was associated with higher utilization of inpatient services, especially for the higher income group. Health insurance members in Vietnam had higher utilization rates of both outpatient and inpatient services than the non-members, with higher use among the lower than higher income groups. Qualitative results show that bureaucratic obstacles, low reimbursement rates, and poor service quality were the main barriers for members to use health insurance. Conclusions China has achieved high population coverage rate over a short time period, starting with a limited benefit package. However, poor people have less benefit from NCMS in terms of health service utilization. Compared to China, Vietnam health insurance system is doing better in equity in health service utilization within the health insurance members. However with low population coverage, a large proportion of population cannot enjoy the health insurance benefit. Mutual learning would help China and Vietnam address these challenges, and improve their policy design to promote equitable and sustainable health insurance. PMID:22376290

77 FR 23265 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... utilization of Medicare services by American Indian and Alaska Native (AI/AN) beneficiaries, to identify and... evaluated previously by any agency or individual, so data on the extent of transportation barriers for rural AI/AN beneficiaries to Medicare services by AI/AN Medicare beneficiaries are not available except...

Charting health system reconstruction in post-war Liberia: a comparison of rural vs. remote healthcare utilization.

PubMed

Kentoffio, Katherine; Kraemer, John D; Griffiths, Thomas; Kenny, Avi; Panjabi, Rajesh; Sechler, G Andrew; Selinsky, Stephen; Siedner, Mark J

2016-09-07

Despite a growing global emphasis on universal healthcare, access to basic primary care for remote populations in post-conflict countries remains a challenge. To better understand health sector recovery in post-conflict Liberia, this paper seeks to evaluate changes in utilization of health services among rural populations across a 5-year time span. We assessed trends in healthcare utilization among the national rural population using the Liberian Demographic and Health Survey (DHS) from 2007 and 2013. We compared these results to results obtained from a two-staged cluster survey in 2012 in the district of Konobo, Liberia, to assess for differential health utilization in an isolated, remote region. Our primary outcomes of interest were maternal and child health service care seeking and utilization. Most child and maternal health indicators improved in the DHS rural sub-sample from 2007 to 2013. However, this progress was not reflected in the remote Konobo population. A lower proportion of women received 4+ antenatal care visits (AOR 0.28, P < 0.001) or any postnatal care (AOR 0.25, P <0.001) in Konobo as compared to the 2013 DHS. Similarly, a lower proportion of children received professional care for common childhood illnesses, including acute respiratory infection (9 % vs. 52 %, P < 0.001) or diarrhea (11 % vs. 46 %, P < 0.001). Our data suggest that, despite the demonstrable success of post-war rehabilitation in rural regions, particularly remote populations in Liberia remain at disproportionate risk for limited access to basic health services. As a renewed effort is placed on health systems reconstruction in the wake of the Ebola-epidemic, a specific focus on solutions to reach isolated populations will be necessary in order to ensure extension of coverage to remote regions such as Konobo.

Negotiating Collective and Individual Agency: A Qualitative Study of Young Women's Reproductive Health in Rural India.

PubMed

Paul, Mandira; Essén, Birgitta; Sariola, Salla; Iyengar, Sharad; Soni, Sunita; Klingberg Allvin, Marie

2017-02-01

The societal changes in India and the available variety of reproductive health services call for evidence to inform health systems how to satisfy young women's reproductive health needs. Inspired by Foucault's power idiom and Bandura's agency framework, we explore young women's opportunities to practice reproductive agency in the context of collective social expectations. We carried out in-depth interviews with 19 young women in rural Rajasthan. Our findings highlight how changes in notions of agency across generations enable young women's reproductive intentions and desires, and call for effective means of reproductive control. However, the taboo around sex without the intention to reproduce made contraceptive use unfeasible. Instead, abortions were the preferred method for reproductive control. In conclusion, safe abortion is key, along with the need to address the taboo around sex to enable use of "modern" contraception. This approach could prevent unintended pregnancies and expand young women's agency.

Program evaluation of remote heart failure monitoring: healthcare utilization analysis in a rural regional medical center.

PubMed

Riley, William T; Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A Susana; Carroll, Mark

2015-03-01

Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.

Pediatric emergency care capabilities of Indian Health Service emergency medical service agencies serving American Indians/Alaska Natives in rural and frontier areas.

PubMed

Genovesi, A L; Hastings, B; Edgerton, E A; Olson, L M

2014-01-01

In the USA, the emergency medical services (EMS) system is vital for American Indians and Alaska Natives, who are disproportionately burdened by injuries and diseases and often live in rural areas geographically far from hospitals. In rural areas, where significant health disparities exist, EMS is often a primary source of healthcare providing a safety net for uninsured individuals or families who otherwise lack access to health-related services. EMS is frequently the first entry point for children and their families into the healthcare system. The Indian Health Service (IHS) supports the federally funded, tribally operated EMS agencies to help meet the affiliated American Indian and Alaska Natives' pre-hospital needs. While periodic assessments of state EMS agencies capabilities to care for children occur, it appears a systematic assessment of IHS EMS agencies in regards to children had not been previously conducted. A consensus process, involving stakeholders, was used to identify topic areas for a survey for assessing the pediatric capabilities of IHS EMS. The survey was sent to 75 of 88 IHS EMS agency contacts. Sixty-one agencies (81%) responded. Nine agencies (15%) did not have a medical director. Agencies without a medical director were less likely to report the availability of online (p=0.1) or offline (p<0.01) pediatric medical direction. Half (51%) of the agencies had a mass casualties plan; however, 29% reported responding to a mass casualty incident, involving a large number of pediatric patients, that overwhelmed their service. Most agencies were well integrated with their state EMS system with almost all (95%) collecting EMS patient care data and 47% using national standard data elements. In some areas, IHS EMS agencies did not have the infrastructure to treat pediatric patients during day-to-day operations as well as disasters. Similar to operational challenges faced by rural EMS agencies, the IHS agencies lacked a medical director, were unable to

Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: A rural vs. urban comparison.

PubMed

Reif, Susan; Whetten, Kathryn; Ostermann, Jan; Raper, James L

2006-01-01

Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about utilization of mental health services among rural-living HIV-infected individuals. This article examines use of mental health services by HIV-infected adults in the Southern U.S., where approximately two-thirds of rural HIV cases reside, and compares mental health services use between those in rural and urban areas. Data were obtained from surveys of HIV-infected individuals receiving care at tertiary Infectious Diseases clinics in the Southern U.S. (n = 474). Study findings indicated that participants living in areas with a higher proportion of rural-living individuals were less likely to report seeing a mental health provider (p < .001) in the last year even though there were no differences in level of psychological distress by degree of rurality. Participants living in more rural areas also reported significantly fewer mental health visits in the previous month (p = .025). Furthermore, rural living was significantly associated with being African-American, heterosexual, less educated, and having minor children in the home. Due to differences in characteristics and mental health services use by degree of rurality, efforts are needed to assess and address the specific mental health and other needs of HIV-infected individuals in rural areas.

17 CFR 250.47 - Exemption of public utility subsidiaries as to certain securities issued to the Rural...

Code of Federal Regulations, 2010 CFR

2010-04-01

... Electrification Administration. (a) Exemption. Any public utility company which is a subsidiary company of a... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Exemption of public utility subsidiaries as to certain securities issued to the Rural Electrification Administration. 250.47 Section 250.47...

75 FR 36349 - Announcement of Rural Cooperative Development Grant Application Deadlines

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-25

... DEPARTMENT OF AGRICULTURE Rural Business-Cooperative Service Announcement of Rural Cooperative Development Grant Application Deadlines AGENCY: Rural Business-Cooperative Service, USDA. ACTION: Notice of...: Overview Federal Agency: Rural Business-Cooperative Service (RBS). Funding Opportunity Title: Rural...

Some Factors Influencing Effective Utilization of Drinking Water Facilities: Women, Income, and Health in Rural North Ghana

NASA Astrophysics Data System (ADS)

Kendie, S. B.

1996-01-01

In the examination of the implementation of rural drinking water facilities, not enough attention has been paid to analyzing the socioeconomic and political relationships that affect the effective utilization of the facilities, particularly as these relate to women in rural society. This paper suggests that much of the difficulty in instituting the utilization of safe water supply sources has to do with the rather low economic status of women—the main water collectors. Poverty consigns women to long periods of work in activities or jobs that bring little reward. This makes it difficult to effectively digest the messages delivered by program staff and limits the extent of usage of the safe water facilities.

Rural Education: Learning to Be Rural Teachers

ERIC Educational Resources Information Center

Barter, Barbara

2008-01-01

Purpose: This paper draws on research which began in 2006 with students in a graduate course on rural education. Its purpose was to find out what graduate students saw as current issues of rural education, how that compared to the literature, and what they thought supporting agencies such as government and universities needed to be doing to…

How does the New Cooperative Medical Scheme influence health service utilization? A study in two provinces in rural China.

PubMed

Yu, Baorong; Meng, Qingyue; Collins, Charles; Tolhurst, Rachel; Tang, Shenglan; Yan, Fei; Bogg, Lennart; Liu, Xiaoyun

2010-05-10

Many countries are developing health financing mechanisms to pursue the goal of universal coverage. In China, a rural health insurance system entitled New Cooperative Medical Scheme (NCMS) is being developed since 2003. Although there is concern about whether the NCMS will influence the serious situation of inequity in health service utilization in rural China, there is only limited evidence available. This paper aims to assess the utilisation of outpatient and inpatient services among different income groups and provinces under NCMS in rural China. Using multistage sampling processes, a cross-sectional household survey including 6,147 rural households and 22,636 individuals, was conducted in six counties in Shandong and Ningxia Provinces, China. Chi-square test, Poisson regression and log-linear regression were applied to analyze the association between NCMS and the utilization of outpatient and inpatient services and the length of stay for inpatients. Qualitative methods including individual interview and focus group discussion were applied to explain and complement the findings from the household survey. NCMS coverage was 95.9% in Shandong and 88.0% in Ningxia in 2006. NCMS membership had no significant association with outpatient service utilization regardless of income level and location.Inpatient service utilization has increased for the high income group under NCMS, but for the middle and low income, the change was not significant. Compared with non-members, NCMS members from Ningxia used inpatient services more frequently, while members from Shandong had a longer stay in hospital.High medical expenditure, low reimbursement rate and difference in NCMS policy design between regions were identified as the main reasons for the differences in health service utilization. Outpatient service utilization has not significantly changed under NCMS. Although utilization of inpatient service in general has increased under NCMS, people with high income tend to benefit

75 FR 21265 - Small, Rural School Achievement Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... DEPARTMENT OF EDUCATION Small, Rural School Achievement Program AGENCY: Office of Elementary and... Federal Domestic Assistance (CFDA) Number: 84.358A. SUMMARY: Under the Small, Rural School Achievement... eligible local educational agencies (LEAs) to address the unique needs of rural school districts. In this...

76 FR 19758 - Small, Rural School Achievement Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

... DEPARTMENT OF EDUCATION Small, Rural School Achievement Program AGENCY: Office of Elementary and... Federal Domestic Assistance (CFDA) Number: 84.358A. SUMMARY: Under the Small, Rural School Achievement... eligible local educational agencies (LEAs) to address the unique needs of rural school districts. In this...

41 CFR 102-83.15 - Is there a general hierarchy of consideration that agencies must follow in their utilization of...

Code of Federal Regulations, 2010 CFR

2010-07-01

... hierarchy of consideration that agencies must follow in their utilization of space? 102-83.15 Section 102-83... general hierarchy of consideration that agencies must follow in their utilization of space? Yes, Federal agencies must follow the hierarchy of consideration identified in § 102-79.55 of this chapter. ...

Personal Factors as Determinants of Utilization of Development Information in Rural Communities of South-South Geo-Political Zone, Nigeria

ERIC Educational Resources Information Center

Edet, Itari Paul; Bullem, Anthony Godwin; Okeme, Isaac

2015-01-01

This study investigated the extent to which personal factors relate to the utilization of development information in the rural communities of South-South Geo-political Zone, Nigeria. The study adopted the descriptive survey design. The population comprised all adult male and female rural dwellers from the three out of the six states in the Zone…

Does the universal health insurance program affect urban-rural differences in health service utilization among the elderly? Evidence from a longitudinal study in taiwan.

PubMed

Liao, Pei-An; Chang, Hung-Hao; Yang, Fang-An

2012-01-01

To assess the impact of the introduction of Taiwan's National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences model was employed and estimated by the random-effect probit method. The introduction of universal NHI in Taiwan heterogeneously affected outpatient and inpatient health service utilization among the elderly in urban and rural areas. The introduction of NHI reduced the disparity of outpatient (inpatient) utilization between the previously uninsured and insured older urban residents by 12.9 (22.0) percentage points. However, there was no significant reduction in the utilization disparity between the previously uninsured and insured elderly among rural residents. Our study on Taiwan's experience should provide a valuable lesson to countries that are in an initial stage of proposing a universal health insurance system. Although NHI is designed to ensure the equitable right to access health care, it may result in differential impacts on health service utilization among the elderly across areas. The rural elderly tend to confront more challenges in accessing health care associated with spatial distance, transportation, social isolation, poverty, and a lack of health care providers, especially medical specialists. © 2011 National Rural Health Association.

Low utilization of HIV testing during pregnancy: What are the barriers to HIV testing for women in rural India?

PubMed

Sinha, Gita; Dyalchand, Ashok; Khale, Manisha; Kulkarni, Gopal; Vasudevan, Shubha; Bollinger, Robert C

2008-02-01

Sixty percent of India's HIV cases occur in rural residents. Despite government policy to expand antenatal HIV screening and prevention of maternal-to-child transmission (PMTCT), little is known about HIV testing among rural women during pregnancy. Between January and March 2006, a cross-sectional sample of 400 recently pregnant women from rural Maharashtra was administered a questionnaire regarding HIV awareness, risk, and history of antenatal HIV testing. Thirteen women (3.3%) reported receiving antenatal HIV testing. Neither antenatal care utilization nor history of sexually transmitted infection (STI) symptoms influenced odds of receiving HIV testing. Women who did not receive HIV testing, compared with women who did, were 95% less likely to have received antenatal HIV counseling (odds ratio = 0.05, 95% confidence interval: 0.02 to 0.17) and 80% less aware of an existing HIV testing facility (odds ratio = 0.19, 95% confidence interval: 0.04 to 0.75). Despite measurable HIV prevalence, high antenatal care utilization, and STI symptom history, recently pregnant rural Indian women report low HIV testing. Barriers to HIV testing during pregnancy include lack of discussion by antenatal care providers and lack of awareness of existing testing services. Provider-initiated HIV counseling and testing during pregnancy would optimize HIV prevention for women throughout rural India.

Health care utilization patterns for young children in rural counties of the I-95 corridor of South Carolina.

PubMed

McElligott, James T; Summer, Andrea P

2013-01-01

The objective of this study was to assess health care utilization patterns for young children with Medicaid insurance in the rural counties of the I-95 corridor in South Carolina relative to other regions of the state. We hypothesize that young children received less well care and higher levels of tertiary care in the rural counties along the I-95 corridor (I-95) of South Carolina. A Medicaid cohort of children less than 3 years of age was used to compare Early, Periodic, Diagnosis, Screening and Treatment (EPSDT) visits; preventable emergency department (ED) visits; and inpatient visits between I-95, other rural and urban county groupings. The adjusted odds of a child having had 80% of the recommended EPSDT visits were reduced for I-95 compared to other rural counties. The odds of a preventable inpatient or ED visit were increased for all rural counties, with the highest rates in the other rural counties. Children accessed well care less in the I-95 corridor compared to other rural areas of South Carolina. Rural children accessed tertiary care more often than urban children, a finding most prominent outside the I-95 corridor, likely attributable to more available access of tertiary care in rural counties outside the I-95 corridor. © 2012 National Rural Health Association.

Rural Communities and Rural Social Issues: Priorities for Research.

ERIC Educational Resources Information Center

Black, Alan; Duff, John; Saggers, Sherry; Baines, Patricia

This report recommends priorities for research into rural communities and rural social issues in Australia, based on an extensive literature review, surveys of policymaking agencies and researchers, and discussion at a national workshop in May 1999. Chapters 1-2 outline the study's background, purpose, and methodology; discuss issues in the…

Utilization of Adult and Non-Formal Education Programs in Combating Rural Poverty in Nigeria

ERIC Educational Resources Information Center

Ihejirika, John Chinedu

2012-01-01

The purpose of this paper was to examine the concept of poverty and its causes in Nigeria and to analyze how adult and non-formal education programs can be utilized to reduce rural poverty in Nigeria. In spite of Nigeria's affluence in human and material resources, it is classified among countries with high level of poverty. Incidentally, the…

Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan

PubMed Central

Memon, Zahid; Zaidi, Shehla; Riaz, Atif

2016-01-01

Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers. PMID:26925902

Urban-rural disparity and determinants of delivery care utilization in Oromia region, Ethiopia: Community-based cross-sectional study.

PubMed

Kenea, Dinke; Jisha, Hunduma

2017-02-01

Low delivery care utilization continues to be a public health problem that significantly contributes to maternal morbidity and mortality, especially in developing countries like Ethiopia. The aim of the study is to determine the extent of urban-rural disparity of delivery care utilization and its determinants. A community-based cross-sectional quantitative study supplemented with qualitative data was conducted from February 15 to March 10, 2014. Data were collected from eligible woman using interviewer-guided semistructured questionnaires and focus group discussions. Logistic regression analysis with 95% confidence interval and p-value less than 5% was used to identify potential determinant variables. From 567 women, institutional delivery care was attended by 45.9% (260) respondents of whom 69.3% were urban and 21.3% were rural. Mass media and antenatal care attendance were the major determinants in urban respondents, whereas children ever born, partners' occupation, women's autonomy, and pregnancy-related health problems were statistically significant associations in rural women. The need for maternal health care is not met to the required level. There is a significant disparity in delivery care attendance among urban and rural women of the study area. Women's empowerment and awareness creation should be extensively worked on through mass media and posters or health information. © 2017 John Wiley & Sons Australia, Ltd.

Omah displacement and utilization from rural to urban areas, as green design lifestyle

NASA Astrophysics Data System (ADS)

Fajarwati, Ade Ariyani Sari

2017-11-01

Building a house in urban area is very costly and also leaving a bunch amount of construction waste. Many efforts were made to reduce the load of this waste. However, the high demand of residences in metropolitan makes the waste problem needs to be solved together. Based on this problem, author chooses Omah, - a Javanese traditional house, which is built, based on the traditional system of life of Javanese people - displacement from rural to urban area as the alternative solution, as it uses selected materials from nature by considering the sustainability and preservation for future generation. The wooden building is built based on traditional construction system that follows Javanese principles and traditional calculation, based on philosophy and cosmology in the community. This paper will covers utilization of Omah in urban area as an implementation of green design, which refers to the concepts of reuse, reduce, recycle and responsibility. Through expert interviews and field surveys in urban and rural areas, author collected data needed for this paper. Although the functionality of the building is different from rural to urban requirements, the phenomenon of Omah displacement from Javanese habitat to urban living area is well accepted and becomes an interesting trend.

76 FR 62055 - Mississippi Delta Energy Agency, Clarksdale Public Utilities Commission, Public Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-64-000; Docket No. ER11-3657-000] Mississippi Delta Energy Agency, Clarksdale Public Utilities Commission, Public Service Commission of Yazoo City, Arkansas Electric Cooperative Corporation, South Mississippi Electric Power...

"Your Mum and Dad Can't Teach You!": Constraints on Agency among Rural Learners of English in the Developing World

ERIC Educational Resources Information Center

Lamb, Martin

2013-01-01

Learning outcomes are always the product of the interaction between individual learner agency and social structures. Recently concern has been expressed about unequal access to English, recognised as an important resource for social advancement, for rural populations in developing countries. This paper explores this issue by focusing on one…

Telehealth Utilization for Chronic Illness and Depression Among Home Health Agencies: A Pilot Survey.

PubMed

Kim, Eunhae; Gellis, Zvi D; Hoak, Vicki

2015-01-01

This pilot survey study explores current telehealth use among home health care agencies for chronic illness and depression care, and identifies factors associated with agencies' perception and intention to use telehealth. Between June and August 2014, 73 directors and 13 staff nurses (N = 86) from the Pennsylvania Homecare Association member agencies participated in an online survey. Eighty-five percent of telehealth provider agencies reported utilizing telehealth for monitoring health status while only 7.7% reported use for depression care. Telehealth technology was more positively perceived for chronic illness care (90.7%) than for depression care (53%) services. Factors associated with positive perceptions of telehealth were identified, including: (a) intention to use or continuing to use telehealth, (b) the size of the agency, (c) the participant's agency role, and (d) existence of depression services. These pilot findings have been used to inform the theoretical framework and the survey instrument for our U.S. national survey.

Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

PubMed

Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

2017-01-01

Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

77 FR 29537 - Standards and Specifications for Timber Products Acceptable for Use by Rural Utilities Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-18

... Timber Products Acceptable for Use by Rural Utilities Service Electric and Telecommunications Borrowers... 44 U.S.C. 1510. #0; #0;The Code of Federal Regulations is sold by the Superintendent of Documents. #0... Construction, by codifying specifications for wood poles, stubs and anchor logs, wood crossarms (solid and...

78 FR 26572 - Rural Call Completion and List of Rural Operating Carrier Numbers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 64 [WC Docket No. 13-39; DA 13-780] Rural Call Completion and List of Rural Operating Carrier Numbers AGENCY: Federal Communications Commission. ACTION: Proposed rule. SUMMARY: In this document, the Federal Communications Commission's Wireline Competition...

Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

PubMed Central

Shrestha, Khadka Narayan; Homer, Caroline S. E.

2017-01-01

Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987

Utilization and management of maternal and child health funds in rural Nepal.

PubMed

Morrison, Joanna; Thapa, Rita; Sen, Aman; Neupane, Rishi; Borghi, Jo; Tumbahangphe, Kirti Man; Osrin, David; Manandhar, Dharma; Costello, Anthony

2010-01-01

Maternal and neonatal mortality rates are highest in the poorest countries, and financial barriers impede access to health care. Community loan funds can increase access to cash in rural areas, thereby reducing delays in care seeking. As part of a participatory intervention in rural Nepal, community women's groups initiated and managed local funds. We explore the factors affecting utilization and management of these funds and the role of the funds in the success of the women's group intervention. We conducted a qualitative study using focus group discussions, group interviews and unstructured observations. Funds may increase access to care for members of trusted 'insider' families adjudged as able to repay loans. Sustainability and sufficiency of funds was a concern but funds increased women's independence and enabled timely care seeking. Conversely, the perceived necessity to contribute may have deterred poorer women. While funds were integral to group success and increased women's autonomy, they may not be the most effective way of supporting the poorest, as the risk pool is too small to allow for repayment default.

75 FR 41695 - Rural Microentrepreneur Assistance Program; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... DEPARTMENT OF AGRICULTURE Rural Business-Cooperative Service 7 CFR Part 4280 RIN 0570-AA71 Rural Microentrepreneur Assistance Program; Correction AGENCY: Rural Business-Cooperative Service, USDA. ACTION... of rural microenterprises. This document has an incorrect definition of ``nonprofit entity...

Self-reported morbidity and health service utilization in rural Tamil Nadu, India.

PubMed

Dodd, Warren; King, Nia; Humphries, Sally; Little, Matthew; Dewey, Cate

2016-07-01

In Tamil Nadu, India, improvements have been made toward developing a high-quality, universally accessible healthcare system. However, some rural residents continue to confront significant barriers to obtaining healthcare. The primary objective of this study was to investigate self-reported morbidity, health literacy, and healthcare preferences, utilization, and experiences in order to identify priority areas for government health policies and programs. Drawing on 66 semi-structured interviews and 300 household surveys (including 1693 individuals), administered in 26 rural villages in Tamil Nadu's Krishnagiri district, we found that the prevalence of self-reported major health conditions was 22.3%. There was a large burden of non-communicable and chronic diseases, and the most common major morbidities were: connective tissue problems (7.6%), nervous system and sense organ diseases (5.0%), and circulatory and respiratory diseases (2.5%). Increased age and decreased education level were associated with higher odds of reporting most diseases. Low health literacy levels resulted in individuals seeking care only once pain interfered with daily activities. As such, individuals' health-seeking behaviour depended on which strategy was believed to result in the fastest return to work using the fewest resources. Although government facilities were the most common healthcare access point, they were mistrusted; 48.8% and 19.2% of respondents perceived inappropriate treatment protocols and corruption, respectively, at public facilities. Conversely, 93.3% of respondents reported high treatment cost as the main barrier to accessing private facilities. Our results highlight that addressing the chronic and non-communicable disease burdens amongst rural populations in this context will require health policies and village-level programs that address the low health literacy and the issues of rural healthcare accessibility and acceptability. Copyright © 2016 Elsevier Ltd. All rights

THE UTILIZATION OF EYE CARE SERVICES BY PERSONS WITH GLAUCOMA IN RURAL SOUTH INDIA

PubMed Central

Robin, Alan L; Nirmalan, Praveen K; Krishnadas, Ramasamy; Ramakrishnan, Rengappa; Katz, Joanne; Tielsch, James; Thulasiraj, Ravilla D; Friedman, David S

2004-01-01

ABSTRACT Purpose To determine utilization of eye care services, in particular those relating to glaucoma, in a rural population of southern India aged 40 years or older. Methods A total of 5,150 subjects aged 40 years or older selected through a random cluster sampling technique from three districts in southern India underwent detailed ocular examinations for vision impairment, blindness, and ocular morbidity. Information regarding previous use of eye care services was collected from this population through a questionnaire administered by trained social workers prior to ocular examinations. Results One thousand eight hundred and twenty-seven persons (35.5%) gave a history of prior eye examinations, primarily from a general hospital (n = 1,073, 58.7%). Increasing age and education were associated with increased utilization of eye care services. Among the 3,323 persons who had never sought eye care, 912 (27.4%) had felt the need to have an eye examination but did not do so. Only one third of persons with vision impairment, cataracts, refractive errors, and glaucoma had previously utilized services. Of the 64 subjects diagnosed as having primary open-angle glaucoma, 32 (50%) had previously seen an ophthalmologist, but none had had an eye examination within 1 year before the study. Only six (19%) of the 32 had been diagnosed as having glaucoma (9% of all subjects found to have glaucoma in the survey). Thirteen (20.3%) of the 64 subjects were blind in either eye due to glaucoma, including one person who was bilaterally blind. Conclusions A large proportion of persons in a rural population of southern India who require eye care are currently not utilizing existing eye care services. Strategies to improve the uptake of services are required to reduce the burden of blindness due to glaucoma in southern India. PMID:15747744

Utilization of Rural Primary Care Physicians' Visit Services for Diabetes Management of Public Health in Southwestern China: A Cross-Sectional Study from Patients' View.

PubMed

Miao, Yudong; Ye, Ting; Qian, Dongfu; Li, Jinlong; Zhang, Liang

2014-06-01

Primary care physicians' visit services for diabetes management are now widely delivered in China's rural public health care. Current studies mainly focus on supply but risk factors from patients' view have not been previously explored. This study aims to present the utilization of rural primary care physicians' visit services for diabetes management in the last 12 months in southwestern China, and to explore risk factors from patients' view. This cross sectional study selected six towns at random and all 385 diabetics managed by primary care physicians were potential participants. Basing on the inclusion and exclusion criteria, 374 diabetics were taken as valid subjects and their survey responses formed the data resource of analyses. Descriptive indicators, χ2 contingency table analyses and Logistic regression were used. 54.8% respondents reported the utilization of visit services. According to the multivariate analysis, the positive factors mainly associated with utilization of visit services include disease duration (OR=1.654), use of diabetic drugs (OR=1.869), consulting diabetes care knowledge (OR=1.602), recognition of diabetic complications (OR=1.662), needs of visit services (OR=2.338). The utilization of rural primary care physicians' visit services still remains unsatisfactory. Mass rural health policy awareness, support, and emphasis are in urgent need and possible risk factors including disease duration, use of diabetic drugs, consulting diabetes care knowledge, recognition of diabetic complications and needs of visit services should be taken into account when making rural health policy of visit services for diabetes management in China and many other low- and middle-income countries.

Measuring Rural Hospital Quality

ERIC Educational Resources Information Center

Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

2004-01-01

Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

Utilizing Chair Massage to Address One Woman's Health in Rural Ghana West Africa: a Case Report.

PubMed

Meryanos, Cathy J

2016-12-01

There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women's health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30-50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45-65 degrees in the right arm, as well as 10-15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries.

Determinants of Utilization of Eye Care Services in a Rural Adult Population of a Developing Country

PubMed Central

Olusanya, Bolutife A.; Ashaye, Adeyinka O.; Owoaje, Eme T.; Baiyeroju, Aderonke M.; Ajayi, Benedictus G.

2016-01-01

Purpose: To describe the factors that determine the utilization of eye care services in a rural community in South-Western Nigeria. Methods: A descriptive cross-sectional survey using a multistage sampling technique was conducted. The main outcome measure was self-reported previous consultation of an orthodox medical facility for eye care. Results: The study sample included 643 participants. Only 122 (19%) respondents had previously visited orthodox facilities in search of eye care and 24% of those with presenting visual acuity <6/18 had sought eye care. Characteristics associated with previous utilization of eye care services were age of =70 years (odds ratio [OR] ≥ 1.7, P = 0.02); male gender (OR = 1.5, P = 0.04); literacy (OR = 1.7, P = 0.007); and residing close to an eye care facility (OR = 2.8, P < 0.001). Blind respondents were three times more likely to seek eye care (P < 0.001). Regression analysis revealed that factors associated with increased likelihood of utilization of eye care services included age ≥70 years; literacy; residence close to an eye facility; being diabetic or hypertensive; history of ocular symptoms, and blindness. Conclusions: These findings suggest that a significant proportion (75%) of adults in the study area are not utilizing eye care services and that blindness is an important determinant of utilization of eye care services. Health education and awareness campaigns about the importance and benefits of seeking eye care early, and the provision of community-based eye care programs are essential to boost the uptake of eye care services in this community as well as other rural areas of West Africa. PMID:26957847

Public Health Agency Accreditation Among Rural Local Health Departments: Influencers and Barriers.

PubMed

Beatty, Kate E; Erwin, Paul Campbell; Brownson, Ross C; Meit, Michael; Fey, James

Health department accreditation is a crucial strategy for strengthening public health infrastructure. The purpose of this study was to investigate local health department (LHD) characteristics that are associated with accreditation-seeking behavior. This study sought to ascertain the effects of rurality on the likelihood of seeking accreditation through the Public Health Accreditation Board (PHAB). Cross-sectional study using secondary data from the 2013 National Association of County & City Health Officials (NACCHO) National Profile of Local Health Departments Study (Profile Study). United States. LHDs (n = 490) that responded to the 2013 NACCHO Profile Survey. LHDs decision to seek PHAB accreditation. Significantly more accreditation-seeking LHDs were located in urban areas (87.0%) than in micropolition (8.9%) or rural areas (4.1%) (P < .001). LHDs residing in urban communities were 16.6 times (95% confidence interval [CI], 5.3-52.3) and micropolitan LHDs were 3.4 times (95% CI, 1.1-11.3) more likely to seek PHAB accreditation than rural LHDs (RLHDs). LHDs that had completed an agency-wide strategic plan were 8.5 times (95% CI, 4.0-17.9), LHDs with a local board of health were 3.3 times (95% CI, 1.5-7.0), and LHDs governed by their state health department were 12.9 times (95% CI, 3.3-50.0) more likely to seek accreditation. The most commonly cited barrier was time and effort required for accreditation application exceeded benefits (73.5%). The strongest predictor for seeking PHAB accreditation was serving an urban jurisdiction. Micropolitan LHDs were more likely to seek accreditation than smaller RLHDs, which are typically understaffed and underfunded. Major barriers identified by the RLHDs included fees being too high and the time and effort needed for accreditation exceeded their perceived benefits. RLHDs will need additional financial and technical support to achieve accreditation. Even with additional funds, clear messaging of the benefits of accreditation

Changes in utilization of health services among poor and rural residents in Uganda: are reforms benefitting the poor?

PubMed

Pariyo, George W; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Rahman, Mohammed Hafizur; Peterson, Stefan; Bishai, David M; Lucas, Henry; Peters, David H

2009-11-12

Uganda implemented health sector reforms to make services more accessible to the population. An assessment of the likely impact of these reforms is important for informing policy. This paper describes the changes in utilization of health services that occurred among the poor and those in rural areas between 2002/3 and 2005/6 and associated factors. Secondary data analysis was done using the socio-economic component of the Uganda National Household Surveys 2002/03 and 2005/06. The poor were identified from wealth quintiles constructed using an asset based index derived from Principal Components Analysis (PCA). The probability of choice of health care provider was assessed using multinomial logistic regression and multi-level statistical models. The odds of not seeking care in 2005/6 were 1.79 times higher than in 2002/3 (OR = 1.79; 95% CI 1.65 - 1.94). The rural population experienced a 43% reduction in the risk of not seeking care because of poor geographical access (OR = 0.57; 95% CI 0.48 - 0.67). The risk of not seeking care due to high costs did not change significantly. Private for profit providers (PFP) were the major providers of services in 2002/3 and 2005/6. Using PFP as base category, respondents were more likely to have used private not for profit (PNFP) in 2005/6 than in 2002/3 (OR = 2.15; 95% CI 1.58 - 2.92), and also more likely to use public facilities in 2005/6 than 2002/3 (OR = 1.31; 95% CI 1.15 - 1.48). The most poor, females, rural residents, and those from elderly headed households were more likely to use public facilities relative to PFP. Although overall utilization of public and PNFP services by rural and poor populations had increased, PFP remained the major source of care. The odds of not seeking care due to distance decreased in rural areas but cost continued to be an important barrier to seeking health services for residents from poor, rural, and elderly headed households. Policy makers should consider targeting subsidies to the poor and

An Inquiry into Rural Dwellers' Opinions about Living Conditions in Urban and Rural Places.

ERIC Educational Resources Information Center

Azarkh, Emilia Davidovna; Korel, Liudmila Vasilyevna

Utilizing data derived from a questionnaire survey of the rural population of Novosibirsk province in the USSR, the following hypothesis was tested: the attitude of rural inhabitants toward urban and rural conditions is characterized by a considerable preponderance of positive evaluations of dominant rural conditions and transient urban conditions…

7 CFR 1951.9 - Distribution of payments when a borrower owes more than one type of FmHA or its successor agency...

Code of Federal Regulations, 2010 CFR

2010-01-01

...-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED... Public Law 103-354 loans. In making such distribution consider the principal balance outstanding on each...) Application of payments. After the decision is reached as to the amount of each payment that is to be...

Utilizing a Low-Cost, Laser-Driven Interactive System (LaDIS) to Improve Learning in Developing Rural Regions

ERIC Educational Resources Information Center

Liou, Wei-Kai; Chang, Chun-Yen

2014-01-01

This study proposes an innovation Laser-Driven Interactive System (LaDIS), utilizing general IWBs (Interactive Whiteboard) didactics, to support student learning for rural and developing regions. LaDIS is a system made to support traditional classroom practices between an instructor and a group of students. This invention effectively transforms a…

"Remnants of feudalism"? Women's health and their utilization of health services in rural China.

PubMed

Anson, O; Haanappel, F W

1999-01-01

Almost five decades ago, the Chinese Communist Party wished to abolish all "remnants of feudalism," including the patriarchal social order. Just one year after the revolution, the Marriage Law endorsed women's rights within the family, but no operative measures were taken to enforce it. Some of the economic reforms since independence even strengthened patrilocality and, possibly, patriarchal values. The purpose of this study was to explore the degree to which patrilocality served to maintain the traditional patriarchal stratification among women in the household by exploring women's health patterns and utilization of health services. Data were collected from 3859 women residing in rural Hebei, and variation in health and help seeking of six categories of relation to household head--mothers, wives, daughters, daughters-in-law, family heads, and other relatives--were explored. Utilization of health services is not dependent on women's position in the household, but primarily on per-capita income. Health patterns seem to indicate that mothers of the head of the household still have a considerable power to define their roles and share of household work. Women head of family, most of whom are married, appear to be under strain, which could be a result of their culturally "deviant" position. We conclude that old patriarchal values are intertwined with values of equality in current rural China.

Utility of a thematic network in primary health care: a controlled interventional study in a rural area

PubMed Central

Coma del Corral, Maria Jesús; Abaigar Luquín, Pedro; Cordero Guevara, José; Olea Movilla, Angel; Torres Torres, Gerardo; Lozano Garcia, Javier

2005-01-01

Background UniNet is an Internet-based thematic network for a virtual community of users (VCU). It supports a virtual multidisciplinary community for physicians, focused on the improvement of clinical practice. This is a study of the effects of a thematic network such as UniNet on primary care medicine in a rural area, specifically as a platform of communication between specialists at the hospital and doctors in the rural area. Methods In order to study the effects of a thematic network such as UniNet on primary care medicine in a rural area, we designed an interventional study that included a control group. The measurements included the number of patient displacements due to disease, number of patient hospital stays and the number of prescriptions of drugs of low therapeutic utility and generic drug prescriptions by doctors. These data were analysed and compared with those of the control center. Results Our study showed positive changes in medical practice, reflected in the improvement of the evaluated parameters in the rural health area where the interventional study was carried out, compared with the control area. We discuss the strengths and weaknesses of UniNet as a potential medium to improve the quality of medical care in rural areas. Conclusion The rural doctors had an effective, useful, user-friendly and cheap source of medical information that may have contributed to the improvement observed in the medical quality indices. PMID:16042778

Cost Effective Delivery Strategies in Rural Areas: Programs for Young Handicapped Children. Vol. I. Making It Work in Rural Communities. A Rural Network Monograph.

ERIC Educational Resources Information Center

Black, Talbot, Ed.; Hutinger, Patricia, Ed.

Using a common format outlining program settings, agencies, children/families served, staff, services, delivery strategies, and program costs, descriptions of four cost-effective rural service delivery programs for young handicapped children provide evidence that good rural programs are affordable. The Early Lifestyle Program at King's Daughters'…

Optimal Design of Biomass Utilization System for Rural Area Includes Technical and Economic Dimensions

NASA Astrophysics Data System (ADS)

Morioka, Yasuki; Nakata, Toshihiko

In order to design optimal biomass utilization system for rural area, OMNIBUS (The Optimization Model for Neo-Integrated Biomass Utilization System) has been developed. OMNIBUS can derive the optimal system configuration to meet different objective function, such as current account balance, amount of biomass energy supply, and CO2 emission. Most of biomass resources in a focused region e.g. wood biomass, livestock biomass, and crop residues are considered in the model. Conversion technologies considered are energy utilization technologies e.g. direct combustion and methane fermentation, and material utilization technologies e.g. composting and carbonization. Case study in Miyakojima, Okinawa prefecture, has been carried out for several objective functions and constraint conditions. Considering economics of the utilization system as a priority requirement, composting and combustion heat utilization are mainly chosen in the optimal system configuration. However gasification power plant and methane fermentation are included in optimal solutions, only when both biomass energy utilization and CO2 reduction have been set as higher priorities. External benefit of CO2 reduction has large impacts on the system configuration. Provided marginal external benefit of more than 50,000 JPY/t-C, external benefit becomes greater than the revenue from electricity and compost etc. Considering technological learning in the future, expensive technologies such as gasification power plant and methane fermentation will have economic feasibility as well as market competitiveness.

Factors associated with utilization of skilled service delivery among women in rural Northern Ghana: a cross sectional study.

PubMed

Gudu, William; Addo, Bright

2017-05-31

Ghana's current Maternal Mortality Ratio (MMR) of 319 per 100,000 live births makes achievement of the Sustainable Development Goal of 70 maternal deaths per 100,000 live births or less by 2030 appear to be illusory. Skilled assistance during childbirth is a critical strategy to reducing maternal mortality, yet the proportion of deliveries taking place within health facilities where such assistance is provided is very low in Ghana, with huge disparity between urban and rural women. To address the gap in skilled attendance in rural Upper East Region, the Ghana Health Service (GHS) in 2005 piloted a program that involved training of Community Health Officers (CHOs) as midwives. This study explored factors associated with skilled delivery services utilization in a predominantly rural district in Ghana. A cross-sectional study, data was collected from a sample of 400 women between the ages of 15 and 49 years who had given birth a year prior to the study. We used frequencies and percentages for descriptive analysis and chi-square (χ 2 ) test for relationship between independents factors and utilization of skilled delivery services. Of the 400 women included in the analysis, 93.3% of them delivered in a health facility. Almost all of the mothers (97.3%) attended or received antenatal care at their last pregnancy with 75.0% of them having four or more ANC visits. The proportion of women who received ANC and utilized skilled delivery services was high (91.5%). Mother's educational attainment, ANC attendance, frequency of ANC visits, satisfaction with ANC services and possession of valid NHIS card significantly associated with utilisation of skilled delivery services. For a predominantly rural district, the percentage of women who deliver within health facilities where skilled assistance is available is very encouraging and a significant stride towards reducing Ghana's overall MMR. Having four or more ANC visits and improving on the quality of care provided has a great

Eliciting and utilizing rural students' funds of knowledge in the service of science learning: An action research study

NASA Astrophysics Data System (ADS)

Lloyd, Ellen M.

Several researchers have pointed out the failures of current schooling to adequately prepare students in science and called for radical reform in science education to address the problem. One dominant critique of science education is that several groups of students are not well served by current school science practices and discourses. Rural students represent one of these underserved populations. Yet, there is little in the literature that speaks specifically to reforming the science education of rural students. Utilizing action research as a methodology, this study was designed to learn more about the unique knowledge and life experiences of rural students, and how these unique knowledge, skills and interests could suggest new ways to improve science education in rural schools. Informed by this ultimate goal, I created an after school science club where the participating high school students engaged in solving a local watershed problem, while explicitly bringing to bear their unique backgrounds, local knowledge and life experiences from living in a rural area of Upstate New York. Using Funds of Knowledge as the theoretical framework, this after-school club served as the context to investigate the following research questions: (1) What science-related funds of knowledge do rural high school students have? (2) How were these funds of knowledge capitalized on to support science learning in an after-school setting?

Dental Care Utilization among North Carolina Rural Older Adults

PubMed Central

Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.

2012-01-01

Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural older adults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural older adults received dental care. Slightly more than one-quarter (27.1%) of dentate rural older adults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural older adults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public health policy to improve the health and quality of life of older adults in rural communities. PMID:22536828

Rural public transportation technologies : user needs and applications

DOT National Transportation Integrated Search

1998-09-01

Rural Intelligent Transportation Systems (ITS) have the ability to meet the needs of travelers in and through rural areas as well as the needs of agencies responsible for the operation and maintenance of rural transportation systems. To assist in the...

Travel time to maternity care and its effect on utilization in rural Ghana: a multilevel analysis.

PubMed

Masters, Samuel H; Burstein, Roy; Amofah, George; Abaogye, Patrick; Kumar, Santosh; Hanlon, Michael

2013-09-01

Rates of neonatal and maternal mortality are high in Ghana. In-facility delivery and other maternal services could reduce this burden, yet utilization rates of key maternal services are relatively low, especially in rural areas. We tested a theoretical implication that travel time negatively affects the use of in-facility delivery and other maternal services. Empirically, we used geospatial techniques to estimate travel times between populations and health facilities. To account for uncertainty in Ghana Demographic and Health Survey cluster locations, we adopted a novel approach of treating the location selection as an imputation problem. We estimated a multilevel random-intercept logistic regression model. For rural households, we found that travel time had a significant effect on the likelihood of in-facility delivery and antenatal care visits, holding constant education, wealth, maternal age, facility capacity, female autonomy, and the season of birth. In contrast, a facility's capacity to provide sophisticated maternity care had no detectable effect on utilization. As the Ghanaian health network expands, our results suggest that increasing the availability of basic obstetric services and improving transport infrastructure may be important interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Skilled delivery care service utilization in Ethiopia: analysis of rural-urban differentials based on national demographic and health survey (DHS) data.

PubMed

Fekadu, Melaku; Regassa, Nigatu

2014-12-01

Despite the slight progress made on Antenatal Care (ANC) utilization, skilled delivery care service utilization in Ethiopia is still far-below any acceptable standards. Only 10% of women receive assistance from skilled birth attendants either at home or at health institutions, and as a result the country is recording a high maternal mortality ratio (MMR) of 676 per 100,000 live births (EDHS, 2011). Hence, this study aimed at identifying the rural-urban differentials in the predictors of skilled delivery care service utilization in Ethiopia. The study used the recent Ethiopian Demographic and Health Survey (EDHS 2011) data. Women who had at least one birth in the five years preceding the survey were included in this study. The data were analyzed using univariate (percentage), bivariate (chi-square) and multivariate (Bayesian logistic regression). The results showed that of the total 6,641 women, only 15.6% received skilled delivery care services either at home or at health institution. Rural women were at greater disadvantage to receive the service. Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization. The findings highlight the need for coordinated effort from government and stakeholders to improve women's education, as well as strengthen community participation. Furthermore, the study recommended the need to scale up the quality of ANC and family planning services backed by improved and equitable access, availability and quality of skilled delivery care services.

Diagnosing water security in the rural North with an environmental security framework.

PubMed

Penn, Henry J F; Loring, Philip A; Schnabel, William E

2017-09-01

This study explores the nature of water security challenges in rural Alaska, using a framework for environmental security that entails four interrelated concepts: availability, access, utility, and stability of water resources. Many researchers and professionals agree that water insecurity is a problem in rural Alaska, although the scale and nature of the problem is contested. Some academics have argued that the problem is systemic, and rooted in an approach to water security by the state that prioritizes economic concerns over public health concerns. Health practitioners and state agencies, on the other hand, contend that much progress has been made, and that nearly all rural households have access to safe drinking water, though many are still lacking 'modern' in-home water service. Here, we draw on a synthesis of ethnographic research alongside data from state agencies to show that the persistent water insecurity problems in rural Alaska are not a problem of access to or availability of clean water, or a lack of 'modern' infrastructure, but instead are rooted in complex human dimensions of water resources management, including the political legacies of state and federal community development schemes that did not fully account for local needs and challenges. The diagnostic approach we implement here helps to identify solutions to these challenges, which accordingly focus on place-based needs and empowering local actors. The framework likewise proves to be broadly applicable to exploring water security concerns elsewhere in the world. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cognitive Appraisals of Specialty Mental Health Services and Their Relation to Mental Health Service Utilization in the Rural Population

ERIC Educational Resources Information Center

Deen, Tisha L.; Bridges, Ana J.; McGahan, Tara C.; Andrews, Arthur R., III

2012-01-01

Purpose: Rural individuals utilize specialty mental health services (eg, psychiatrists, psychologists, counselors, and social workers) at lower rates than their urban counterparts. This study explores whether cognitive appraisals (ie, individual perceptions of need for services, outcome expectancies, and value of a positive therapeutic outcome) of…

Northeast Florida rural transit intelligent transportation system

DOT National Transportation Integrated Search

2003-02-01

The Northeast Florida Rural Transit Intelligent Transportation System (ITS) project was a demonstration of ITS deployment by four rural Community Transportation Coordinator agencies. The objective of the project was to test and evaluate the effective...

75 FR 33573 - Rural Housing Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... Housing Program (GRRHP) Demonstration Program for Fiscal Year 2010; Correction AGENCY: Rural Housing... in the Federal Register of May 10, 2010, announcing the implementation of a demonstration program under the section 538 Guaranteed Rural Rental Housing Program (GRHHP) for Fiscal Year 2010. A correction...

Need for Improvement of Rural School Facilities.

ERIC Educational Resources Information Center

Hodges, V. Pauline

The Government Accounting Agency estimates that one third of the nation's schools are in need of extensive repairs or replacement of one or more buildings. The condition of America's rural schools are at a crisis stage and need to be improved to continue to educate rural youth. This paper profiles the state of rural schools' infrastructure, rural…

77 FR 35657 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-14

... Information Collection Activity; Comment Request AGENCY: Rural Utilities Service, USDA. ACTION: Notice and... 35, as amended), the United States Department of Agriculture (USDA) Rural Development administers rural utilities programs through the Rural Utilities Service. The USDA Rural Development invites...

Computerized Management Information System in a Community Health Nursing Agency

PubMed Central

Simmons, DeLanne A.

1981-01-01

The Visiting Nurse Association of Omaha is a nonprofit, voluntary agency providing home health care, preventive care, clinical services, and school health services in an urban-rural setting. It has developed a computerized system which provides for: (1) centralized dictation by service delivery staff; (2) the printing of a uniform clinical, family problem-oriented record; (3) an integrated data base, statistical system, and financial system; and (4) the communication capability to remote stations. (The hardware utilized is an IBM System 34.) Cost effectiveness has been demonstrated by a reduction in cost of visit from $47.02 to $43.79.

77 FR 26735 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... AGENCY: Rural Utilities Service, USDA. ACTION: Notice and request for comments. SUMMARY: In accordance... Department of Agriculture (USDA) Rural Development administers rural utilities programs through the Rural Utilities Service (RUS). The USDA Rural Development invites comments on the following information...

Determinants of Utilization of Antenatal Care Services in Rural Lucknow, India

PubMed Central

Roy, Manas P.; Mohan, Uday; Singh, Shivendra K.; Singh, Vijay K.; Srivastava, Anand K.

2013-01-01

Background: Antenatal care services are the first steps towards ensuring the health of mothers and the newborn. This is the key component for achieving Millennium Development Goals by 2015. But India's performance continues to be poor in providing antenatal care services to its huge population, particularly in the rural areas. Objective: To assess the determinants of utilization of antenatal services by rural beneficiaries in Lucknow, a district of north India. Materials and Methods: The study, cross-sectional in design, was conducted from August 2009 to July 2010. Multistage random sampling was used for selecting villages. A total of 352 recently delivered women were selected following systematic random sampling. Logistic regression was used to find out the determinants of three antenatal care services. Results: Overall, 85.5% of the beneficiaries surveyed were found to receive at least three antenatal care services from any health facility. Community health centre was the most common source for such care. Significant difference was found between beneficiaries who took three antenatal care visits and who did not in terms of age, socio economic status, and timing of registration. On multiple regression, only age (OR = 2.107, 95% CI = 1.132 – 3.923) and timing of registration (OR = 2.817, 95% CI = 1.487 – 5.338) were found to be the predictors for three antenatal care visits. Conclusion: Intervention should be focused on young and late registered women for ensuring sufficient care during pregnancy. PMID:24479045

7 CFR 4290.130 - Identified Rural Areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... specific Rural Area or Areas in which it intends to make Developmental Venture Capital investments and... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM...

Sustainable Energy Solutions for Rural Alaska

DOE Office of Scientific and Technical Information (OSTI.GOV)

Allen, Riley; Brutkoski, Donna; Farnsworth, David

2016-04-22

The state of Alaska recognizes the challenges these rural communities face and provides financial support via the Power Cost Equalization (PCE) program. The PCE subsidizes the electricity prices paid by customers of these high-cost utilities. The PCE program is designed to spread the benefits of Alaska’s natural resources more evenly throughout the state. Yet even with this subsidy, electricity is still much more expensive for these rural customers. And beyond the PCE, other forms of assistance to rural utilities are becoming scarce given the state’s current fiscal environment. Nearly 90 percent of Alaska’s unrestricted budget funds in recent years havemore » been tied to oil royalties—a sector experiencing significant declines in production and oil prices. Consequently, as Alaska looks to tighten budgets, the challenge of lowering rural utility costs, while encouraging self-sufficiency, has become more urgent.This study examines reliability, capital and strategic planning, management, workforce development, governance, financial performance and system efficiency in the various communities visited by the research team. Using those attributes, a tier system was developed to categorize rural Alaska utilities into Leading and Innovating Systems (Tier I), Advanced Diesel Systems (Tier II), Basic Systems (Tier III), and Underperforming Systems (Tier IV). The tier approach is not meant to label specific utilities, but rather to provide a general set of benchmarks and guideposts for improvement.« less

41 CFR 102-79.55 - Is there a general hierarchy of consideration that agencies must follow in their utilization of...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Is there a general hierarchy of consideration that agencies must follow in their utilization of space? 102-79.55 Section 102-79... Utilization of Space Utilization of Space § 102-79.55 Is there a general hierarchy of consideration that...

Utilizing Chair Massage to Address One Woman’s Health in Rural Ghana West Africa: a Case Report

PubMed Central

Meryanos, Cathy J.

2016-01-01

Background and Objectives There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women’s health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. Case Presentation The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30–50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. Results The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45–65 degrees in the right arm, as well as 10–15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. Discussion This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries. PMID:27974948

49 CFR Appendix B to Part 218 - Statement of Agency Enforcement Policy on Blue Signal Protection for Utility Employees

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Statement of Agency Enforcement Policy on Blue... on Blue Signal Protection for Utility Employees The following examples of the application of the train or yard crew exclusion from required blue signal protection for utility employees are provided to...

49 CFR Appendix B to Part 218 - Statement of Agency Enforcement Policy on Blue Signal Protection for Utility Employees

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Statement of Agency Enforcement Policy on Blue... on Blue Signal Protection for Utility Employees The following examples of the application of the train or yard crew exclusion from required blue signal protection for utility employees are provided to...

49 CFR Appendix B to Part 218 - Statement of Agency Enforcement Policy on Blue Signal Protection for Utility Employees

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Statement of Agency Enforcement Policy on Blue... on Blue Signal Protection for Utility Employees The following examples of the application of the train or yard crew exclusion from required blue signal protection for utility employees are provided to...

49 CFR Appendix B to Part 218 - Statement of Agency Enforcement Policy on Blue Signal Protection for Utility Employees

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Statement of Agency Enforcement Policy on Blue... on Blue Signal Protection for Utility Employees The following examples of the application of the train or yard crew exclusion from required blue signal protection for utility employees are provided to...

49 CFR Appendix B to Part 218 - Statement of Agency Enforcement Policy on Blue Signal Protection for Utility Employees

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Statement of Agency Enforcement Policy on Blue... on Blue Signal Protection for Utility Employees The following examples of the application of the train or yard crew exclusion from required blue signal protection for utility employees are provided to...

Improving safety on rural local and tribal roads safety toolkit.

DOT National Transportation Integrated Search

2014-08-01

Rural roadway safety is an important issue for communities throughout the country and presents a challenge for state, local, and Tribal agencies. The Improving Safety on Rural Local and Tribal Roads Safety Toolkit was created to help rural local ...

Rural Public Transportation Technologies: User Needs and Applications. Tech Brief.

DOT National Transportation Integrated Search

1998-09-01

Rural Intelligent Transportation Systems (ITS) have the ability to meet the needs of travelers in and through rural areas as well as the needs of agencies responsible for the operation and maintenance of rural transportation systems. To assist in the...

Influencing Self-Reported Health among Rural Low-Income Women through Health Care and Social Service Utilization: A Structural Equation Model

ERIC Educational Resources Information Center

Bice-Wigington, Tiffany; Huddleston-Casas, Catherine

2012-01-01

Using structural equation modeling, this study examined the mesosystemic processes among rural low-income women, and how these processes subsequently influenced self-reported health. Acknowledging the behavioral processes inherent in utilization of health care and formal social support services, this study moved beyond a behavioral focus by…

Training for Agriculture and Rural Development--1975.

ERIC Educational Resources Information Center

United Nations Food and Agriculture Organization, Rome (Italy).

Eighteen papers about education, training, and extension in rural areas of the developing world are presented in this 1975 journal published jointly by three United Nations agencies closely concerned with education and rural development: Food and Agriculture Organization; Education, Scientific, and Cultural Organization; International Labor…

Rural Child Sexual Abuse Prevention and Treatment.

ERIC Educational Resources Information Center

Ray, JoAnn; Murty, Susan A.

1990-01-01

Reviews literature on rural child sexual abuse and treatment. Surveys providers in rural Washington treatment programs. Responses describe agency characteristics, services, delivery problems, and suggested solutions. Reports providers' perceptions of service quality and interagency cooperation. Cites as problems heavy caseloads, lack of staff, and…

The role of rural nurse managers in supporting new graduate nurses in rural practice.

PubMed

Lea, Jackie; Cruickshank, Mary

2017-04-01

To investigate the nature and timing of support available to new graduate nurses within a rural transition to practice programme. For new graduates in rural practice successful transition is complicated by the unique role of the rural nurse, staff ratios and resources within rural environments. Little is known about the support needs of graduates working in rural health services, or who is best placed to provide support during their transition. This was a qualitative case study, using individual interviews with new graduate nurses at 3, 6 and 9 months milestones during a 12-month rural transition to practice programme plus interviews with experienced rural nurses who were employed in rural health agencies where the new graduate nurses were employed. Graduates in rural health services rely on nurse unit managers and nurse managers for feedback, support and debriefing, provision of emotional support, advocacy, openness, encouragement and protection from organisational requests and demands during the transition to rural nursing practice. Nurse managers play an important role in rural health services in the provision of support for new graduate nurses. As clinical leaders rural nurse managers and nurse unit managers, have an important role in facilitating the successful entry and retention of new graduate nurses into the rural nursing workforce. © 2016 John Wiley & Sons Ltd.

42 CFR 447.371 - Services furnished by rural health clinics.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Institutional and Noninstitutional Services Rural Health Clinic Services § 447.371 Services furnished by rural health clinics. The agency must pay for rural health clinic services, as defined in § 440.20(b) of this subchapter, and for other ambulatory services furnished by a rural health clinic, as defined in § 440.20(c...

Remoteness and maternal and child health service utilization in rural Liberia: A population–based survey

PubMed Central

Kenny, Avi; Basu, Gaurab; Ballard, Madeleine; Griffiths, Thomas; Kentoffio, Katherine; Niyonzima, Jean Bosco; Sechler, G. Andrew; Selinsky, Stephen; Panjabi, Rajesh R.; Siedner, Mark J.; Kraemer, John D.

2015-01-01

Background This study seeks to understand distance from health facilities as a barrier to maternal and child health service uptake within a rural Liberian population. Better understanding the relationship between distance from health facilities and rural health care utilization is important for post–Ebola health systems reconstruction and for general rural health system planning in sub–Saharan Africa. Methods Cluster–sample survey data collected in 2012 in a very rural southeastern Liberian population were analyzed to determine associations between quartiles of GPS–measured distance from the nearest health facility and the odds of maternal (ANC, facility–based delivery, and PNC) and child (deworming and care seeking for ARI, diarrhea, and fever) service use. We estimated associations by fitting simple and multiple logistic regression models, with standard errors adjusted for clustered data. Findings Living in the farthest quartile was associated with lower odds of attending 1–or–more ANC checkup (AOR = 0.04, P < 0.001), 4–or–more ANC checkups (AOR = 0.13, P < 0.001), delivering in a facility (AOR = 0.41, P = 0.006), and postnatal care from a health care worker (AOR = 0.44, P = 0.009). Children living in all other quartiles had lower odds of seeking facility–based fever care (AOR for fourth quartile = 0.06, P < 0.001) than those in the nearest quartile. Children in the fourth quartile were less likely to receive deworming treatment (AOR = 0.16, P < 0.001) and less likely (but with only marginal statistical significance) to seek ARI care from a formal HCW (AOR = 0.05, P = 0.05). Parents in distant quartiles more often sought ARI and diarrhea care from informal providers. Conclusions Within a rural Liberian population, distance is associated with reduced health care uptake. As Liberia rebuilds its health system after Ebola, overcoming geographic disparities, including through further

Remoteness and maternal and child health service utilization in rural Liberia: A population-based survey.

PubMed

Kenny, Avi; Basu, Gaurab; Ballard, Madeleine; Griffiths, Thomas; Kentoffio, Katherine; Niyonzima, Jean Bosco; Sechler, G Andrew; Selinsky, Stephen; Panjabi, Rajesh R; Siedner, Mark J; Kraemer, John D

2015-12-01

This study seeks to understand distance from health facilities as a barrier to maternal and child health service uptake within a rural Liberian population. Better understanding the relationship between distance from health facilities and rural health care utilization is important for post-Ebola health systems reconstruction and for general rural health system planning in sub-Saharan Africa. Cluster-sample survey data collected in 2012 in a very rural southeastern Liberian population were analyzed to determine associations between quartiles of GPS-measured distance from the nearest health facility and the odds of maternal (ANC, facility-based delivery, and PNC) and child (deworming and care seeking for ARI, diarrhea, and fever) service use. We estimated associations by fitting simple and multiple logistic regression models, with standard errors adjusted for clustered data. Living in the farthest quartile was associated with lower odds of attending 1-or-more ANC checkup (AOR = 0.04, P < 0.001), 4-or-more ANC checkups (AOR = 0.13, P < 0.001), delivering in a facility (AOR = 0.41, P = 0.006), and postnatal care from a health care worker (AOR = 0.44, P = 0.009). Children living in all other quartiles had lower odds of seeking facility-based fever care (AOR for fourth quartile = 0.06, P < 0.001) than those in the nearest quartile. Children in the fourth quartile were less likely to receive deworming treatment (AOR = 0.16, P < 0.001) and less likely (but with only marginal statistical significance) to seek ARI care from a formal HCW (AOR = 0.05, P = 0.05). Parents in distant quartiles more often sought ARI and diarrhea care from informal providers. Within a rural Liberian population, distance is associated with reduced health care uptake. As Liberia rebuilds its health system after Ebola, overcoming geographic disparities, including through further dissemination of providers and greater use of community health

SYNTHESIS OF THE RURAL MODEL REVIEWS

EPA Science Inventory

The Environmental Protection Agency has undertaken an independent review of eight rural diffusion models, two of which were developed by the EPA; the remaining six were submitted to the EPA for approval by outside agencies and consulting firms. In the first phase of the review pr...

Effect of the new rural cooperative medical system on farmers' medical service needs and utilization in Ningbo, China.

PubMed

Chen, Jianhua; Yu, Hai; Dong, Hengjin

2016-10-20

Many countries are developing health mechanisms to pursue the goal of universal coverage. In China, a rural health insurance system entitled New Cooperative Medical System (NCMS) has being developed since 2003. This paper aims to explore the changes in the health service needs and utilization among rural residents in Ningbo, China after the implementation of the new rural cooperative medical system (NCMS), and provide evidence to further improve the strategies of NCMS in China. Stratified multistage cluster sampling was used to randomly select 10 villages from 5 townships in Yuyao and Fenghua counties of Ningbo Municipality. Eighty families were selected from each village, and face-to-face interviews were conducted by trained investigators to collect data using questionnaires. The two-week visiting rate and prevalence of chronic diseases among the farmers included in the study was 25.40 and 22.50 %, respectively, which were higher than the levels in 2003 and 2008. The rate of not visiting the healthcare facility amongst those with illness, and the rate of non- hospitalization amongst those who required it were 32.36 and 0.60 %, respectively, which was lower than the levels in 2003 and 2008. Most of the outpatient visits were to the village clinics, while the hospitalizations were mainly to county hospitals. NCMS greatly affected the utilization of healthcare services from outpatient clinics and improved the hospitalization rate in county hospitals. Financial difficulties are not the major causes of non-hospitalization and non-visiting any longer. These findings suggest that the NCMS policies alleviated the medical burdens of farmers in a certain degree.

Adapting Road Safety Audits to Local Rural Roads

DOT National Transportation Integrated Search

1998-10-01

Many rural governments do not have an effective safety improvement program for their roads, yet crash rates are significantly higher on rural roads than on urban, state, and federal roads. Smaller agencies seldom have the financial resources or exper...

Does proximity of women to facilities with better choice of contraceptives affect their contraceptive utilization in rural Ethiopia?

PubMed Central

Spigt, Mark; Seme, Assefa; Amogne, Ayanaw; Skrøvseth, Stein; Desta, Selamawit; Radloff, Scott; GeertJan, Dinant

2017-01-01

Background There is limited evidence of the linkage between contraceptive use, the range of methods available and level of contraceptive stocks at health facilities and distance to facility in developing countries. The present analysis aims at examining the influence of contraceptive method availability and distance to the nearby facilities on modern contraceptive utilization among married women in rural areas in Ethiopia using geo-referenced data. Methods We used data from the first round of surveys of the Performance Monitoring & Accountability 2020 project in Ethiopia (PMA2020/Ethiopia-2014). The survey was conducted in a sample of 200 enumeration areas (EAs) where for each EA, 35 households and up to 3 public or private health service delivery points (SDPs) were selected. The main outcome variable was individual use of a contraceptive method for married women in rural Ethiopia. Correlates of interest include distance to nearby health facilities, range of contraceptives available in facilities, household wealth index, and the woman’s educational status, age, and parity and whether she recently visited a health facility. This analysis primarily focuses on stock provision at public SDPs. Results Overall complete information was collected from 1763 married rural women ages 15–49 years and 198 SDPs in rural areas (97.1% public). Most rural women (93.9%) live within 5 kilometers of their nearest health post while a much lower proportion (52.2%) live within the same distance to the nearest health centers and hospital (0.8%), respectively. The main sources of modern contraceptive methods for married rural women were health posts (48.8%) and health centers (39.0%). The mean number of the types of contraceptive methods offered by hospitals, health centers and health posts was 6.2, 5.4 and 3.7 respectively. Modern contraceptive use (mCPR) among rural married women was 27.3% (95% CI: 25.3, 29.5). The percentage of rural married women who use modern contraceptives

Does proximity of women to facilities with better choice of contraceptives affect their contraceptive utilization in rural Ethiopia?

PubMed

Shiferaw, Solomon; Spigt, Mark; Seme, Assefa; Amogne, Ayanaw; Skrøvseth, Stein; Desta, Selamawit; Radloff, Scott; Tsui, Amy; GeertJan, Dinant

2017-01-01

There is limited evidence of the linkage between contraceptive use, the range of methods available and level of contraceptive stocks at health facilities and distance to facility in developing countries. The present analysis aims at examining the influence of contraceptive method availability and distance to the nearby facilities on modern contraceptive utilization among married women in rural areas in Ethiopia using geo-referenced data. We used data from the first round of surveys of the Performance Monitoring & Accountability 2020 project in Ethiopia (PMA2020/Ethiopia-2014). The survey was conducted in a sample of 200 enumeration areas (EAs) where for each EA, 35 households and up to 3 public or private health service delivery points (SDPs) were selected. The main outcome variable was individual use of a contraceptive method for married women in rural Ethiopia. Correlates of interest include distance to nearby health facilities, range of contraceptives available in facilities, household wealth index, and the woman's educational status, age, and parity and whether she recently visited a health facility. This analysis primarily focuses on stock provision at public SDPs. Overall complete information was collected from 1763 married rural women ages 15-49 years and 198 SDPs in rural areas (97.1% public). Most rural women (93.9%) live within 5 kilometers of their nearest health post while a much lower proportion (52.2%) live within the same distance to the nearest health centers and hospital (0.8%), respectively. The main sources of modern contraceptive methods for married rural women were health posts (48.8%) and health centers (39.0%). The mean number of the types of contraceptive methods offered by hospitals, health centers and health posts was 6.2, 5.4 and 3.7 respectively. Modern contraceptive use (mCPR) among rural married women was 27.3% (95% CI: 25.3, 29.5). The percentage of rural married women who use modern contraceptives decreased as distance from the

Improving safety on rural local and tribal roads.

DOT National Transportation Integrated Search

2014-08-01

Rural roadway safety is an important issue for communities throughout the country and presents a challenge for local and Tribal agencies. The FHWA created a Toolkit and two User Guides to help rural local and Tribal roadway safety practitioners addre...

Sexual and reproductive healthcare utilization among women aged 40 to 49 in rural China.

PubMed

Sun, Xiaoming; Sun, Yu; Zong, Zhanhong; Shu, Xingyu; Mao, Jingshu; Hearst, Norman

2016-10-01

China's national family planning system is mainly directed toward women of early reproductive ages. Most studies of service provision focused on younger women, who almost all receive regular examinations. Little is known about service-seeking behavior among women of late reproductive ages. This cross-sectional household survey interviewed 1,811 rural women aged 40 to 49 in seven provinces. We examined sexual and reproductive health, utilization of sexual and reproductive health services, and predictors of receiving a free gynecological examination in the past 2 years. Educational levels were not high, and most women were rural farmers or housewives. More than one-fourth had migrated for work to big cities when they were younger. The mean frequency of sex in the last month was 3.6 times. Approximately 22.7% of women had not received a gynecological examination and 31.2% had not received any health education during the past 2 years. The first choice for where to seek services was township medical facilities (58.4%). On multivariate regression, age, education, migrant working experience, awareness of the need for intrauterine device removal after menopause, health education received, and attitude toward health examinations were significantly associated with receiving a gynecological examination in the past 2 years. Women of late reproductive age in rural China are not receiving as regular care as younger women. This study identifies sociodemographic and health service correlates for service-seeking behavior, many of which are modifiable. Health services should pay greater attention to this group, including community-based efforts to encourage routine examinations and appropriate use of health services.

Challenges for a Local Service Agency to Address Domestic Violence –A Case Study From Rural Indonesia

PubMed Central

Hayati, Elli Nur; Emmelin, Maria; Eriksson, Malin

2014-01-01

Since the launch of a Zero Tolerance Policy in Indonesia, several policies to address domestic violence have been enacted. The obligation of local governments to establish service units for women survivors of domestic violence is one of them. Since domestic violence is a sensitive and complex issue in Indonesia it is important to understand how governmentally regulated services function in practice. This case study aimed to explore challenges faced by a local service agency in managing service provision for women survivors of domestic violence in rural Indonesia. Data from one focus group discussion (12 participants), four individual interviews, six short narratives, two days of participant observation, as well as archive reviews were collected. All data were analyzed using Grounded Theory Situational Analysis. The major challenge faced by the local agency was the low priority that was given them by the local authorities, mirrored also in low involvement by the assigned volunteers in the daily service. The study also identified a gap between the socio-cultural arena and the law & policy arena that needs to be bridged to avoid that the two arenas address domestic violence in a contradictory way. Budget allocation to support the sustainability of the daily routines of service agencies has to be given priority. There is also a need for careful considerations regarding the composition of personnel involved within daily management of service agencies addressing domestic violence. To bridge the gap between the legal systems and traditional cultural values, culturally adjusted alternative justice systems could be developed to increase women’s access to legal support. PMID:25363105

78 FR 41363 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-10

... care opportunities. The Agency provides financial assistance to eligible entities that are proposing to... DEPARTMENT OF AGRICULTURE Rural Utilities Service Information Collection Activity; Comment Request AGENCY: Rural Utilities Service, USDA. ACTION: Notice and request for comments. SUMMARY: In accordance...

Rural Women's Transitions to Motherhood: Understanding Social Support in a Rural Community

ERIC Educational Resources Information Center

Gjesfjeld, Christopher D.; Weaver, Addie; Schommer, Kathryn

2012-01-01

Social support protects women from various negative consequences, yet we have little understanding of how rural women acquire and utilize social support. Using interviews of 24 women in a North Dakota community, this research sought to understand how rural women were supported as new mothers. One, familial women and partners were vital supports to…

Access and adequate utilization of malaria control interventions in rural Malawi: a descriptive quantitative study.

PubMed

Kabaghe, Alinune Nathanael; Chipeta, Michael Give; McCann, Robert Sean; Terlouw, Dianne Jean; Tizifa, Tinashe; Truwah, Zinenani; Phiri, Kamija Samuel; van Vugt, Michèle

2018-03-06

Despite the availability of cost effective malaria control interventions, such as insecticide-treated bed nets (ITN), diagnosis and effective treatment of malaria, and intermittent preventive treatment during pregnancy (IPTp), the lack of equitable access and coverage affect utilization of these interventions in rural communities. Aggregated rates of access and utilization of malaria interventions in national surveys mask substantial variations in intervention coverage. Utilization of interventions and factors affecting utilization need investigation in rural communities. One year of quantitative data collected from a rolling Malaria Indicator Survey (April 2015-April 2016) in Chikhwawa District, Malawi, before the ITN distribution campaign, were analysed. Univariate analyses were used to quantify rates of ITN usage, care-seeking for fever in children aged 6-59 months and women aged 15-49 years and IPTp uptake (for women aged 15-49 years with a recent delivery). Results were compared to national survey estimates; factors associated with these outcomes were determined using multivariate regression models. A total of 2046 participants were included from 1328 households; 56.6% were women aged 15-49 years and 43.4% were children aged 6-59 months. Reported ownership of at least one ITN per household and under-five children ITN use the previous night were 35.3 and 33.5% compared to 70.2 and 67.1%, respectively, in the national survey; ITN use was higher in high wealth quintile households than low quintile ones. For participants with recent fever, 37.6 and 19.5% sought care and sought care within 24 h, respectively. Care-seeking was lower for febrile women than febrile children [aOR, 95% CI 0.53 (0.35-0.81)]. Uptake of two and three or more doses of IPTp were 40.6 and 15.0%, respectively, among women with a pregnancy in the last 2 years. To achieve effective malaria control, fine-scale or district-based surveillance should be used to identify and target communities

A New Frontier: Utilizing Charter Schooling to Strengthen Rural Education

ERIC Educational Resources Information Center

Smarick, Andy

2014-01-01

This report, the first in the series, points out that, while urban families increasingly have access to a variety of school options--including charter schools--many rural families have just a single school option. There are numerous examples of rural charter schools that have done great things for students while also benefiting the larger…

Echocardiogram Utilization among Rural and Urban Veterans

ERIC Educational Resources Information Center

Okrah, Kingston; Vaughan-Sarrazin, Mary; Kaboli, Peter; Cram, Peter

2012-01-01

Purpose: To compare echocardiography use among urban and rural veterans and whether differences could be accounted for by distance. Methods: We used Veterans Administration (VA) administrative data from 1999 to 2007 to identify regular users of the VA Healthcare System (VA users) who did and did not receive echocardiography. Each veteran was…

76 FR 13125 - Announcement of Grant Application Deadlines and Funding Levels; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Announcement of Grant Application Deadlines and Funding Levels; Correction AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Solicitation of Applications; correction. SUMMARY: The United States Department of Agriculture's (USDA) Rural Utilities Service...

ITS concepts for rural corridor management.

DOT National Transportation Integrated Search

2007-09-01

The Arizona Department of Transportations (ADOT) SPR-570: Rural ITS Progress Study - Arizona 2004 provided : 20 key recommendations for improved utilization of the rural ITS (Intelligent Transportation Systems) infrastructure. : Two years later, i...

76 FR 12017 - Announcement of Grant Application Deadlines and Funding Levels

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Announcement of Grant Application Deadlines and Funding Levels AGENCY: Rural Utilities Service, USDA. ACTION: Notice of solicitation of applications. SUMMARY: The United States Department of Agriculture's (USDA) Rural Utilities Service (RUS) announces the...

7 CFR 3560.260 - Rental subsidies from non-Agency sources.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 3560.260 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE DIRECT MULTI-FAMILY HOUSING LOANS AND GRANTS Rental Subsidies § 3560... subsidies from sources other than the Agency in Agency financed housing projects. The Agency will make no...

7 CFR 1940.304 - Special policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM... successor agency under Public Law 103-354 recognizes that its specific mission of assisting rural areas...

Rural black women's agency within intimate partnerships amid the South African HIV epidemic.

PubMed

Thege, Britta

2009-12-01

In a particular way, the HIV pandemic exposes the prevailing gender relations and the definitions of male and female gender roles, both in intimate relationships and in the wider society. The HIV pandemic reveals the contradictions between women's legal rights and the persistence of women's cultural and sexual subordination. It reflects the impact of poverty, gender roles, culture and religion. Although HIV and AIDS cuts across class, South African rural black women's infection risk seems particularly high since they suffer notably from subordination and socio-economic hardships. Negotiating safer sex in marriage or intimate partnerships is very difficult for them in view of the traditional spaces in which they find themselves, where patriarchal structures are pervasive. Based on data obtained from a case study, this paper examines socio-cultural constraints to rural women's sexual agency in a patriarchal social order. These rules are based on a patriarchal code of respect, which is still pervasive in many aspects of the community under investigation. In terms of gender relations, the patriarchal code of respect is founded on an assumed 'naturalisation' of the two genders and the natural superiority of the male over the female. In terms of sexuality it is translated into male sex-right. The fear of HIV infection is omnipresent and results in unmarried women engaging in the negotiation of their wants and needs. Owing to the patriarchal code of respect, married women are perceived as having no choice in negotiating safer sex and are forced to put their lives at risk in contracting HIV. Unmarried women have greater although not endless choices in this regard. Although the study participants unexpectedly displayed a rather negative perception of other women, in order to strengthen women in their proximal environment the HIV epidemic may be seen as a vehicle for building solidarity among women in the community.

Northeast Florida rural transit intelligent transportation system (ITS) : evaluation plan

DOT National Transportation Integrated Search

2001-05-01

The Northeast Florida Rural Transportation Intelligent Transportation System (ITS) project is a demonstration of ITS deployment in five rural Community Transportation Coordinator (CTC) agencies. The objective of the project is to test and evaluate th...

75 FR 44757 - Notice of Funding Availability (NOFA) Inviting Applications for the Rural Microentrepreneur...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-29

... DEPARTMENT OF AGRICULTURE Rural Business-Cooperative Service Notice of Funding Availability (NOFA) Inviting Applications for the Rural Microentrepreneur Assistance Program AGENCY: Rural Business-Cooperative.... Canales, Administrator, Rural Business-Cooperative Service. [FR Doc. 2010-18639 Filed 7-28-10; 8:45 am...

75 FR 22550 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-29

..., filing of petitions and applications and agency #0;statements of organization and functions are examples... American Recovery and Reinvestment Act of 2009 (Recovery Act). The agencies provide grants, loans and loan guarantee assistance to rural residents, rural communities, and rural utility systems. Rural Housing Service...

78 FR 70915 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Information Collection Activity; Comment Request AGENCY: Rural Utilities Service, USDA. ACTION: Notice and request for comments. SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35, as amended), the Rural Utilities...

75 FR 51977 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Information Collection Activity; Comment Request AGENCY: Rural Utilities Service, USDA. ACTION: Notice and request for comments. SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35, as amended), the Rural Utilities...

The impact of economic growth on health care utilization: a longitudinal study in rural Vietnam.

PubMed

Thoa, Nguyen Thi Minh; Thanh, Nguyen Xuan; Chuc, Nguyen Thi Kim; Lindholm, Lars

2013-03-16

In many developing countries, including Vietnam, out-of-pocket payment is the principal source of health financing. The economic growth is widening the gap between rich and poor people in many aspects, including health care utilization. While inequities in health between high- and low-income groups have been well investigated, this study aims to investigate how the health care utilization changes when the economic condition is changing at a household level. We analysed a panel data of 11,260 households in a rural district of Vietnam. Of the sample, 74.4% having an income increase between 2003 and 2007 were defined as households with economic growth. We used a double-differences propensity score matching technique to compare the changes in health care expenditure as percentage of total expenditure and health care utilization from 2003 to 2005, from 2003 to 2007, and from 2005 to 2007, between households with and without economic growth. Households with economic growth spent less percentage of their expenditure for health care, but used more provincial/central hospitals (higher quality health care services) than households without economic growth. The differences were statistically significant. The results suggest that households with economic growth are better off also in terms of health services utilization. Efforts for reducing inequalities in health should therefore consider the inequality in income growth over time.

7 CFR 1951.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM... subpart does not apply to Water and Waste Programs of the Rural Utilities Service, Watershed loans, or..., this subpart is inapplicable to Farm Service Agency, Farm Loan Programs. [52 FR 26134, July 13, 1987...

7 CFR 1951.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM... subpart does not apply to Water and Waste Programs of the Rural Utilities Service, Watershed loans, or..., this subpart is inapplicable to Farm Service Agency, Farm Loan Programs. [52 FR 26134, July 13, 1987...

78 FR 17418 - Rural Health Information Technology Network Development Grant

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

... Information Technology Network Development Grant AGENCY: Health Resources and Services Administration (HRSA...-competitive replacement award under the Rural Health Information Technology Network Development Grant (RHITND... relinquishing its fiduciary responsibilities for the Rural Health Information Technology Network Development...

Southern Rural Development Center Annual Progress Report, 1996.

ERIC Educational Resources Information Center

Southern Rural Development Center, Mississippi State, MS.

This annual report of the Southern Rural Development Center (SRDC) describes the agency's extension and research activities from October 1, 1995, to October 1, 1996. SRDC is one of four regional centers coordinating rural development research and extension education programs cooperatively with the land-grant institutions. SRDC cooperates with 29…

Validating an Agency-based Tool for Measuring Women's Empowerment in a Complex Public Health Trial in Rural Nepal.

PubMed

Gram, Lu; Morrison, Joanna; Sharma, Neha; Shrestha, Bhim; Manandhar, Dharma; Costello, Anthony; Saville, Naomi; Skordis-Worrall, Jolene

2017-01-02

Despite the rising popularity of indicators of women's empowerment in global development programmes, little work has been done on the validity of existing measures of such a complex concept. We present a mixed methods validation of the use of the Relative Autonomy Index for measuring Amartya Sen's notion of agency freedom in rural Nepal. Analysis of think-aloud interviews ( n  = 7) indicated adequate respondent understanding of questionnaire items, but multiple problems of interpretation including difficulties with the four-point Likert scale, questionnaire item ambiguity and difficulties with translation. Exploratory Factor Analysis of a calibration sample ( n  = 511) suggested two positively correlated factors ( r  = 0.64) loading on internally and externally motivated behaviour. Both factors increased with decreasing education and decision-making power on large expenditures and food preparation. Confirmatory Factor Analysis on a validation sample ( n  = 509) revealed good fit (Root Mean Square Error of Approximation 0.05-0.08, Comparative Fit Index 0.91-0.99). In conclusion, we caution against uncritical use of agency-based quantification of women's empowerment. While qualitative and quantitative analysis revealed overall satisfactory construct and content validity, the positive correlation between external and internal motivations suggests the existence of adaptive preferences. High scores on internally motivated behaviour may reflect internalized oppression rather than agency freedom.

Synthesis of Iowa research to address rural safety : [tech transfer summary].

DOT National Transportation Integrated Search

2014-10-01

Information about roadway departures, rural intersections, and : rural speed management countermeasures relevant to Iowa was : summarized on webpages (www.ctre.iastate.edu/research-synthesis/) : to allow agencies to more effectively target specific t...

Rural-to-urban migration and its implication for new cooperative medical scheme coverage and utilization in China.

PubMed

Qiu, Peiyuan; Yang, Yang; Zhang, Juying; Ma, Xiao

2011-06-30

China has been experiencing the largest rural to urban migration in history. Rural-to-urban migrants are those who leave their hometown for another place in order to work or live without changing their hukou status, which is a household registration system in China, categorizing people as either rural residents or urban residents. Rural-to-urban migrants typically find better job opportunities in destination cities, and these pay higher salaries than available in their home regions. This has served to improve the enrollment rates in the New Cooperative Medical Scheme (NCMS) of rural families, protecting households from falling into poverty due to diseases. However, current regulations stipulate that people who are registered in China's rural hukou can only participate in their local NCMS, which in turn poses barriers when migrants seek medical services in the health facilities of their destination cities. To examine this issue in greater depth, this study examined the associations between migration, economic status of rural households, and NCMS enrollment rate, as well as NCMS utilization of rural-to-urban migrants. A multistage cluster sampling procedure was adopted. Our sample included 9,097 households and 36,720 individuals. Chi-square test and T-test were used to examine differences between the two populations of migrants and non-migrants based on age, gender, marriage status, and highest level of education. Ordinal logistic regression was used to examine the association between migration and household economic status. Binary logistic regression was used to examine the associations between household economic status, migration and enrollment in the NCMS. Migration was positively associated with improved household economic status. In households with no migrants, only 11.3% of the population was in the richest quintile, whereas the percentage was more than doubled in households with family members who migrated in 2006. Among those using in-patient medical services

Rural-to-urban migration and its implication for new cooperative medical scheme coverage and utilization in China

PubMed Central

2011-01-01

Background China has been experiencing the largest rural to urban migration in history. Rural-to-urban migrants are those who leave their hometown for another place in order to work or live without changing their hukou status, which is a household registration system in China, categorizing people as either rural residents or urban residents. Rural-to-urban migrants typically find better job opportunities in destination cities, and these pay higher salaries than available in their home regions. This has served to improve the enrollment rates in the New Cooperative Medical Scheme (NCMS) of rural families, protecting households from falling into poverty due to diseases. However, current regulations stipulate that people who are registered in China's rural hukou can only participate in their local NCMS, which in turn poses barriers when migrants seek medical services in the health facilities of their destination cities. To examine this issue in greater depth, this study examined the associations between migration, economic status of rural households, and NCMS enrollment rate, as well as NCMS utilization of rural-to-urban migrants. Methods A multistage cluster sampling procedure was adopted. Our sample included 9,097 households and 36,720 individuals. Chi-square test and T-test were used to examine differences between the two populations of migrants and non-migrants based on age, gender, marriage status, and highest level of education. Ordinal logistic regression was used to examine the association between migration and household economic status. Binary logistic regression was used to examine the associations between household economic status, migration and enrollment in the NCMS. Results Migration was positively associated with improved household economic status. In households with no migrants, only 11.3% of the population was in the richest quintile, whereas the percentage was more than doubled in households with family members who migrated in 2006. Among those using

Computerized Coordinated Service Center: A Comparison of Service Methodologies and Costs in the Urban and Rural Area.

ERIC Educational Resources Information Center

Waldman, Risa J.; And Others

Ten parallel human service agencies (five urban and five rural) were compared to identify variations in the service delivery system and to compare the costs of service provision. The agencies responded to approximately 36 questions covering eight major areas and were compared and contrasted, urban versus rural, according to the type of agency. All…

Rural Passenger Mobility in the 1990s: Emerging Local Solutions.

ERIC Educational Resources Information Center

Stommes, Eileen S.

1990-01-01

Describes current changes in rural transportation services. Describes general thrust of innovative efforts to provide rural passenger transportation despite declining resources. Describes public-private transportation cooperation, human-service agency coordination, linking state and local bus services, mixed passenger-package functions, community…

Factors associated with patterns of plural healthcare utilization among patients taking antiretroviral therapy in rural and urban South Africa: a cross-sectional study

PubMed Central

2012-01-01

Background In low-resource settings, patients’ use of multiple healthcare sources may complicate chronic care and clinical outcomes as antiretroviral therapy (ART) continues to expand. However, little is known regarding patterns, drivers and consequences of using multiple healthcare sources. We therefore investigated factors associated with patterns of plural healthcare usage among patients taking ART in diverse South African settings. Methods A cross-sectional study of patients taking ART was conducted in two rural and two urban sub-districts, involving 13 accredited facilities and 1266 participants selected through systematic random sampling. Structured questionnaires were used in interviews, and participant’s clinic records were reviewed. Data collected included household assets, healthcare access dimensions (availability, affordability and acceptability), healthcare utilization and pluralism, and laboratory-based outcomes. Multiple logistic regression models were fitted to identify predictors of healthcare pluralism and associations with treatment outcomes. Prior ethical approval and informed consent were obtained. Results Nineteen percent of respondents reported use of additional healthcare providers over and above their regular ART visits in the prior month. A further 15% of respondents reported additional expenditure on self-care (e.g. special foods). Access to health insurance (Adjusted odds ratio [aOR] 6.15) and disability grants (aOR 1.35) increased plural healthcare use. However, plural healthcare users were more likely to borrow money to finance healthcare (aOR 2.68), and incur catastrophic levels of healthcare expenditure (27%) than non-plural users (7%). Quality of care factors, such as perceived disrespect by staff (aOR 2.07) and lack of privacy (aOR 1.50) increased plural healthcare utilization. Plural healthcare utilization was associated with rural residence (aOR 1.97). Healthcare pluralism was not associated with missed visits or biological

Factors associated with patterns of plural healthcare utilization among patients taking antiretroviral therapy in rural and urban South Africa: a cross-sectional study.

PubMed

Moshabela, Mosa; Schneider, Helen; Silal, Sheetal P; Cleary, Susan M

2012-07-02

In low-resource settings, patients' use of multiple healthcare sources may complicate chronic care and clinical outcomes as antiretroviral therapy (ART) continues to expand. However, little is known regarding patterns, drivers and consequences of using multiple healthcare sources. We therefore investigated factors associated with patterns of plural healthcare usage among patients taking ART in diverse South African settings. A cross-sectional study of patients taking ART was conducted in two rural and two urban sub-districts, involving 13 accredited facilities and 1266 participants selected through systematic random sampling. Structured questionnaires were used in interviews, and participant's clinic records were reviewed. Data collected included household assets, healthcare access dimensions (availability, affordability and acceptability), healthcare utilization and pluralism, and laboratory-based outcomes. Multiple logistic regression models were fitted to identify predictors of healthcare pluralism and associations with treatment outcomes. Prior ethical approval and informed consent were obtained. Nineteen percent of respondents reported use of additional healthcare providers over and above their regular ART visits in the prior month. A further 15% of respondents reported additional expenditure on self-care (e.g. special foods). Access to health insurance (Adjusted odds ratio [aOR] 6.15) and disability grants (aOR 1.35) increased plural healthcare use. However, plural healthcare users were more likely to borrow money to finance healthcare (aOR 2.68), and incur catastrophic levels of healthcare expenditure (27%) than non-plural users (7%). Quality of care factors, such as perceived disrespect by staff (aOR 2.07) and lack of privacy (aOR 1.50) increased plural healthcare utilization. Plural healthcare utilization was associated with rural residence (aOR 1.97). Healthcare pluralism was not associated with missed visits or biological outcomes. Increased plural

41 CFR 102-74.310 - What measures must Federal agencies take to improve the utilization of parking facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What measures must Federal agencies take to improve the utilization of parking facilities? 102-74.310 Section 102-74.310...

Expanding health insurance to increase health care utilization: will it have different effects in rural vs. urban areas?

PubMed

Erlyana, Erlyana; Damrongplasit, Kannika Kampanya; Melnick, Glenn

2011-05-01

This study investigates the importance of medical fee and distance to health care provider on individual's decision to seek care in developing countries. The estimation method used a mixed logit model applied to data from the third wave of the Indonesian family life survey (2000). The key variables of interest include medical fee and distance to different types of health care provider and individual characteristic variables. Urban dweller's decision to choose health care providers are sensitive to the monetary cost of medical care as measured by medical fee but they are not sensitive to distance. For those who reside in rural area, they are sensitive to the non-medical component cost of care as measured by travel distance but they are not sensitive to medical fee. As a result of those findings, policy makers should consider different sets of policy instruments when attempting to expand health service's usage in urban and rural areas of Indonesia. To increase access in urban areas, we recommend expansion of health insurance coverage in order to lower out-of-pocket medical expenditures. As for rural areas, expansion of medical infrastructures to reduce commuting distance and costs will be needed to increase utilization. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

RH knowledge and service utilization among unmarried rural-to-urban migrants in three major cities, China

PubMed Central

2011-01-01

Background Large numbers of unmarried migrants are on the continuous move from rural-to-urban areas within China mainland, meanwhile their Reproductive Health (RH) is underserved when it is compared with the present urban RH policies. The purpose of this study is to investigate the RH knowledge and the utilization of RH services among unmarried migrants. Methods A cross-section survey was performed in three cities in China-Shenzhen, Guangzhou and Wuhan. A total of 3,450 rural-to-urban unmarried migrants were chosen according to a purposive sampling method. Around 3,412 (male: 1,680, female: 1,732) were qualified for this study. A face-to-face structured questionnaire survey was used, which focused on the knowledge concerning "fertility, contraception and STD/AIDS," as well as RH service utilization. Results Among unmarried migrants the RH knowledge about pregnancy-fertilization (29.4%) and contraception (9.1%) was at its lowest level. Around 21% of unmarried migrants had pre-marital sexual experience and almost half (47.4%) never used condoms during sexual intercourse. The most obtained RH services was about STD/AIDS health education (female: 49.6%, male: 50.2%) and free prophylactic use of contraceptives and/or condoms (female: 42.5%, male: 48.3%). As for accessing RH checkup services it was at its lowest level among females (16.1%). Those who migrated to Shenzhen (OR = 0.64) and Guangzhou (OR = 0.53) obtained few RH consultations compared to those in Wuhan. The white collar workers received more RH consultations and checkup services than the blue collar workers (all group P < 0.01). Conclusion RH knowledge and the utilization of RH services amongst unmarried migrants remain insufficient in the three studied major cities. This study reveals the important gaps in the RH services' delivery, and highlights the requirements for tailored interventions, including further research, to address more effectively the demands and the needs of the unmarried migrant populations

76 FR 22608 - Notice of a Public Meeting on the Rural Energy for America Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... DEPARTMENT OF AGRICULTURE Rural Business-Cooperative Service 7 CFR Part 4280 Notice of a Public Meeting on the Rural Energy for America Program AGENCY: Rural Business-Cooperative Service, USDA. ACTION: Notice of public meeting. SUMMARY: The Rural Business-Cooperative Service (RBS) will hold two...

7 CFR 1944.423 - Loan packaging and 502 RH application submittal.

Code of Federal Regulations, 2010 CFR

2010-01-01

... or its successor agency under Public Law 103-354's ultimate decision making authority to approve or... HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY...

Integrating the Arts in Rural Schools.

ERIC Educational Resources Information Center

Galles, Karen

1986-01-01

Describes integrated approach to teaching the arts which can be utilized in single or multi-grade classrooms in rural settings by teachers who may not have a background in any art form. Addresses problems of time, preparation, and resources that hinder curriculum development by rural educators. (NEC)

Capacity Building for Rural Development in the United States.

ERIC Educational Resources Information Center

Murray, Michael; Dunn, Larry

1995-01-01

An essential component of community-based rural development is the leadership and problem-solving abilities of local people. The Colorado Rural Revitalization Project--a joint venture of two universities and a state agency--provided educational, consultative, and technical assistance services for a 1-year capacity-building program in 47…

Validating an Agency-based Tool for Measuring Women’s Empowerment in a Complex Public Health Trial in Rural Nepal

PubMed Central

Gram, Lu; Morrison, Joanna; Sharma, Neha; Shrestha, Bhim; Manandhar, Dharma; Costello, Anthony; Saville, Naomi; Skordis-Worrall, Jolene

2017-01-01

Abstract Despite the rising popularity of indicators of women’s empowerment in global development programmes, little work has been done on the validity of existing measures of such a complex concept. We present a mixed methods validation of the use of the Relative Autonomy Index for measuring Amartya Sen’s notion of agency freedom in rural Nepal. Analysis of think-aloud interviews (n = 7) indicated adequate respondent understanding of questionnaire items, but multiple problems of interpretation including difficulties with the four-point Likert scale, questionnaire item ambiguity and difficulties with translation. Exploratory Factor Analysis of a calibration sample (n = 511) suggested two positively correlated factors (r = 0.64) loading on internally and externally motivated behaviour. Both factors increased with decreasing education and decision-making power on large expenditures and food preparation. Confirmatory Factor Analysis on a validation sample (n = 509) revealed good fit (Root Mean Square Error of Approximation 0.05–0.08, Comparative Fit Index 0.91–0.99). In conclusion, we caution against uncritical use of agency-based quantification of women’s empowerment. While qualitative and quantitative analysis revealed overall satisfactory construct and content validity, the positive correlation between external and internal motivations suggests the existence of adaptive preferences. High scores on internally motivated behaviour may reflect internalized oppression rather than agency freedom. PMID:28303173

Stakeholder benefit from depression disease management: differences by rurality?

PubMed

Xu, Stanley; Rost, Kathryn; Dong, Fran; Dickinson, L Miriam

2011-01-01

Despite increasing consensus about the value of depression disease management programs, the field has not identified which stakeholders should absorb the relatively small additional costs associated with these programs. This paper investigates whether two proposed stakeholders (health plans and employer purchasers) economically benefit from depression care management (reduced outpatient utilization and work costs, respectively) in two delivery systems (rural and urban). This study examined the main and differential effects of depression care management on outpatient utilization and work costs over 24 months in a preplanned secondary analysis of 479 depressed patients from rural and urban primary care practices in a randomized controlled trial. Over 24 months, the intervention did not significantly reduce outpatient utilization costs in the entire cohort (-$191, 95% confidence interval (CI)=-$2,083 to $1,647), but it did decrease work costs (-$1,970, 95% CI=-$3,934 to -$92). While not statistically significant, rural-urban differences in work costs were in the same direction, while rural-urban differences in utilization costs differed in direction. These findings provide preliminary evidence that employers who elect to cover depression care management costs should receive comparable economic benefits in the rural and urban employees they insure. Given the limited sample size, further research may be needed to determine whether health plans who elect to cover depression care management costs will receive comparable economic benefits in the rural and urban enrollees they insure.

Research on Employment in the Rural Nonfarm Sector in Africa. African Rural Employment Paper No. 5.

ERIC Educational Resources Information Center

Liedholm, Carl

Within the context of the role of rural employment in overall economic development, the objectives were to summarize existing knowledge of the rural African nonfarm sector and to develop an analytical framework for examing utilization of labor in this sector, using a descriptive profile, a theoretical model, and a research approach to rural…

76 FR 73648 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-29

... burden; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4... collection; Title of Information Collection: Request for Certification as a Rural Health Clinic Form and... of Rural Health Clinic (RHC) Services under the Medicare/ Medicaid Program, is utilized as an...

Signs of Progress: A Report on Rural America's Revitalization Efforts.

ERIC Educational Resources Information Center

Department of Agriculture, Washington, DC.

This report outlines the major rural development programs and initiatives of the Department of Agriculture and other federal agencies. Diverse economic realities make necessary differential rural development policies and programs. The federal budget deficit makes it necessary that the government use creative and efficient management techniques to…

Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey.

PubMed

Adewuyi, Emmanuel O; Zhao, Yun; Auta, Asa; Lamichhane, Reeta

2017-08-01

The aim of this study was to assess the rural-urban differences in the prevalence and factors associated with non-utilization of healthcare facility for childbirth (home delivery) in Nigeria. Dataset from the Nigeria demographic and health survey, 2013, disaggregated by rural-urban residence were analyzed with appropriate adjustment for the cluster sampling design of the survey. Factors associated with home delivery were identified using multivariable logistic regression analysis. In rural and urban residence, the prevalence of home delivery were 78.3% and 38.1%, respectively ( p < 0.001). The lowest prevalence of home delivery occurred in the South-East region for rural residence (18.6%) and the South-West region for urban residence (17.9%). The North-West region had the highest prevalence of home delivery, 93.6% and 70.5% in rural and urban residence, respectively. Low maternal as well as paternal education, low antenatal attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West and the South-South regions increased the likelihood of home delivery in both rural and urban residences. Whether in rural or urban residence, birth order of one decreased the likelihood of home delivery. In rural residence only, living in the North-Central region increased the chances of home delivery. In urban residence only, maternal age ⩾ 36 years decreased the likelihood of home delivery, while 'Traditionalist/other' religion and maternal age < 20 years increased it. The prevalence of home delivery was much higher in rural than urban Nigeria and the associated factors differ to varying degrees in the two residences. Future intervention efforts would need to prioritize findings in this study.

Rural and urban transit district benchmarking : effectiveness and efficiency guidance document.

DOT National Transportation Integrated Search

2011-05-01

Rural and urban transit systems have sought ways to compare performance across agencies, : identifying successful service delivery strategies and applying these concepts to achieve : successful results within their agency. Benchmarking is a method us...

Typology of Leisure of Rural People.

ERIC Educational Resources Information Center

Tapilina, Vera Sergeevna

Utilizing data from a 1972 sociological survey of rural inhabitants working in the public economy of the province of Novosibirsk, this study examined leisure as an element of the residents' life style. Rural residents with common leisure behaviors were identified through the classification of the behavior's function and quality. Leisure functions…

77 FR 41369 - Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Availability of a Final Environmental Impact Statement. SUMMARY: Notice is hereby given that the Rural...

Predictors of Antenatal Care, Skilled Birth Attendance, and Postnatal Care Utilization among the Remote and Poorest Rural Communities of Zambia: A Multilevel Analysis.

PubMed

Jacobs, Choolwe; Moshabela, Mosa; Maswenyeho, Sitali; Lambo, Nildah; Michelo, Charles

2017-01-01

Optimal utilization of maternal health-care services is associated with reduction of mortality and morbidity for both mothers and their neonates. However, deficiencies and disparity in the use of key maternal health services within most developing countries still persist. We examined patterns and predictors associated with the utilization of specific indicators for maternal health services among mothers living in the poorest and remote district populations of Zambia. A cross-sectional baseline household survey was conducted in May 2012. A total of 551 mothers with children between the ages 0 and 5 months were sampled from 29 catchment areas in four rural and remote districts of Zambia using the lot quality assurance sampling method. Using multilevel modeling, we accounted for individual- and community-level factors associated with utilization of maternal health-care services, with a focus on antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC). Utilization rates of focused ANC, SBA, and PNC within 48 h were 30, 37, and 28%, respectively. The mother's ability to take an HIV test and receiving test results and uptake of intermittent preventive treatment for malaria were positive predictors of focused ANC. Receiving ANC at least once from skilled personnel was a significant predictor of SBA and PNC within 48 h after delivery. Women who live in centralized rural areas were more likely to use SBA than those living in remote rural areas. Utilization of maternal health services by mothers living among the remote and poor marginalized populations of Zambia is much lower than the national averages. Finding that women that receive ANC once from a skilled attendant among the remote and poorest populations are more likely to have a SBA and PNC, suggests the importance of contact with a skilled health worker even if it is just once, in influencing use of services. Therefore, it appears that in order for women in these marginalized communities to

Portrait of rural emergency departments in Québec and utilization of the provincial emergency department management Guide: cross sectional survey.

PubMed

Fleet, Richard; Poitras, Julien; Archambault, Patrick; Tounkara, Fatoumata Korika; Chauny, Jean-Marc; Ouimet, Mathieu; Gauthier, Josée; Dupuis, Gilles; Tanguay, Alain; Lévesque, Jean-Frédéric; Simard-Racine, Geneviève; Haggerty, Jeannie; Légaré, France

2015-12-23

Rural emergency departments (EDs) constitute crucial safety nets for the 20% of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access to services than do other provinces. A difference that may be attributable to provincial policy/guidelines "the provincial ED management Guide". The aim of this study was to provide a detailed description of rural EDs in Québec and utilization of the provincial ED management Guide. We selected EDs offering 24/7 medical coverage, with hospitalization beds, located in rural or small towns. We collected data via telephone, paper, and online surveys with rural ED/hospital staff. Data were also collected from Québec's Ministry of Health databases and from Statistics Canada. We computed descriptive statistics, ANOVA and t-tests were used to examine the relationship between ED census, services and inter-facility transfer requirements. A total of 23 of Québec's 26 rural EDs (88%) consented to participate in the study. The mean annual ED visits was 18 813 (Standard Deviation = 6 151). Thirty one percent of ED physicians were recent graduates with fewer than 5 years of experience. Only 6 % had residency training or certification in emergency medicine. Teams have good local access (24/7) to diagnostic equipment such as CT scanner (74%), intensive unit care (78%) and general surgical services (78%), but limited access to other consultants. Sixty one percent of participants have reported good knowledge of the provincial ED management Guide, but only 23% of them have used the guidelines. Furthermore, more than 40% of EDs were more than 300 km from levels 1 to 2 trauma centers, and only 30% had air transport access. Rural EDs in Québec are staffed by relatively new graduates working as solo physicians in well-resourced and moderately busy (by rural standards) EDs. The provincial ED management Guide may have contributed to this model of service attribution. However, the

Towards the Social and Economic Promotion of Rural Women in Tanzania

ERIC Educational Resources Information Center

Kokuhirwa, Hilda

1975-01-01

The report describes the changing image of women in rural Tanzania and the various agencies responsible for their social, economic, cultural, and political promotion in rural areas, including the Tanganyika African National Union (TANU), and the Union of Women in Tanganyika (UWT). (LH)

77 FR 52758 - Agency Information Collection Activities under OMB Review; Renewal of a Currently Approved...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... OMB Review; Renewal of a Currently Approved Collection; Reclamation Rural Water Supply Program AGENCY... and Budget (OMB) for review and approval: Reclamation Rural Water Supply Program, OMB Control Number... Supply Program (Rural Water Program) to submit information to allow the Bureau of Reclamation to evaluate...

Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.

PubMed

O'Gorman, Laurel D; Hogenbirk, John C; Warry, Wayne

2016-06-01

Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care. There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south. Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.

7 CFR 1948.92 - Grant approval and fund obligation.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... 1900-B. (d) If a grant is recommended, Form FmHA or its successor agency under Public Law 103-354 440-1...

Utilisation and costs of nursing agencies in the South African public health sector, 2005-2010.

PubMed

Rispel, Laetitia C; Angelides, George

2014-01-01

Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6-2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year

Can a chronic disease management pulmonary rehabilitation program for COPD reduce acute rural hospital utilization?

PubMed

Rasekaba, T M; Williams, E; Hsu-Hage, B

2009-01-01

Chronic obstructive pulmonary disease (COPD) imposes a costly burden on healthcare. Pulmonary rehabilitation (PR) is the best practice to better manage COPD to improve patient outcomes and reduce acute hospital care utilization. To evaluate the impact of a once-weekly, eight-week multidisciplinary PR program as an integral part of the COPD chronic disease management (CDM) Program at Kyabram District Health Services. The study compared two cohorts of COPD patients: CDM-PR Cohort (4-8 weeks) and Opt-out Cohort (0-3 weeks) between February 2006 and March 2007. The CDM-PR Program involved multidisciplinary patient education and group exercise training. Nonparametric statistical tests were used to compare acute hospital care utilization 12 months before and after the introduction of CDM-PR. The number of patients involved in the CDM-PR Cohort was 29 (n = 29), and that in the Opt-out Cohort was 24 (n = 24). The CDM-PR Cohort showed significant reductions in cumulative acute hospital care utilization indicators (95% emergency department presentations, 95% inpatient admissions, 99% length of stay; effect sizes = 0.62-0.66, P < 0.001) 12 months after the introduction of the CDM Program; in contrast, changes in the cumulative indicators were statistically insignificant for the Opt-out Cohort (emergency department presentations decreased by 5%, inpatient admissions decreased by 12%, length of stay increased by 30%; effect size = 0.14-0.40, P > 0.05). Total costs associated with the hospital care utilization decreased from $130,000 to $7,500 for the CDM-PR Cohort and increased from $77,700 to $101,200 for the Opt-out Cohort. Participation in the CDM-PR for COPD patients can significantly reduce acute hospital care utilization and associated costs in a small rural health service.

Choice of personal assistance services providers by medicare beneficiaries using a consumer-directed benefit: rural-urban differences.

PubMed

Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R; Van Nostrand, Joan F; Eggert, Gerald M

2010-01-01

To examine the impact of an experimental consumer-choice voucher benefit on the selection of independent and agency personal assistance services (PAS) providers among rural and urban Medicare beneficiaries with disabilities. The Medicare Primary and Consumer-Directed Care Demonstration enrolled 1,605 Medicare beneficiaries in 19 counties in New York State, West Virginia, and Ohio. A total of 839 participants were randomly assigned to receive a voucher benefit (up to $250 per month with a 20% copayment) that could be used toward PAS provided by either independent or agency workers. A bivariate probit model was used to estimate the probabilities of choosing either type of PAS provider while controlling for potential confounders. The voucher was associated with a 32.4% (P < .01) increase in the probability of choosing agency providers and a 12.5% (P= .03) increase in the likelihood of choosing independent workers. When the analysis was stratified by rural/urban status, rural voucher recipients had 36.8% higher probability of using independent workers compared to rural controls. Urban voucher recipients had 37.1% higher probability of using agency providers compared to urban controls. This study provided evidence that rural and urban Medicare beneficiaries with disabilities may have very different responses to a consumer-choice PAS voucher program. Offering a consumer-choice voucher option to rural populations holds the potential to significantly improve their access to PAS. © 2010 National Rural Health Association.

Home health care agency staffing patterns before and after the Balanced Budget Act of 1997, by rural and urban location.

PubMed

McAuley, William J; Spector, William; Van Nostrand, Joan

2008-01-01

The Balanced Budget Act (BBA) of 1997 and other recent policies have led to reduced Medicare funding for home health agencies (HHAs) and visits per beneficiary. We examine the staffing characteristics of stable Medicare-certified HHAs across rural and urban counties from 1996 to 2002, a period encompassing the changes associated with the BBA and related policies. Data were drawn from Medicare Provider of Service files and the Area Resource File. The unit of analysis was the 3,126 counties in the United States, grouped into 5 categories: metropolitan, nonmetropolitan adjacent, and 3 nonmetropolitan nonadjacent groups identified by largest town size. Only relatively stable HHAs were included. We generated summary HHA staff statistics for each county group and year. All staff categories, other than therapists, declined from 1997 to 2002 across the metropolitan and nonmetropolitan county groupings. There were substantial population-adjusted decreases in stable HHA-based home health aides in all counties, including remote counties. The limited presence of stable HHA staff in certain nonmetropolitan county types has been exacerbated since implementation of the BBA, especially in the most rural counties. The loss of aides in more rural counties may limit the availability of home-based long-term care in these locations, where the need for long-term care is considerable. Future research should examine the degree to which the presence of HHA staff influences actual access and whether other paid and unpaid sources of care substitute for Medicare home health care in counties with limited supplies of HHA staff.

Perceptions of the Importance and Utilization of Clinical Supervision among Certified Rural School Counselors

ERIC Educational Resources Information Center

Duncan, Kelly; Brown-Rice, Kathleen; Bardhoshi, Gerta

2014-01-01

This study explored rural school counselors' perceptions of clinical supervision. School counselors working in rural communities commonly encounter issues that challenge their ability to provide competent counseling services to the students they serve. School counselors serving in these areas are often the only rural mental health provider in…

76 FR 13420 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

... in rural areas, for the planning and implementation of integrated health care networks in rural areas... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities: Submission for OMB Review; Comment Request Periodically, the Health...

Empowered women from rural areas of Bolivia promote community development.

PubMed

Ríos, Roxana; Olmedo, Catón; Fernández, Luis

2007-01-01

Abstract: The United States Agency for Development in Bolivia (USAID/Bolivia) created in 2002 PROSALUD- Partners for Development Project (PfD) with the aim of improving the population's well-being. The project used three components: small grant scheme, technical assistance and database system management. Through the small grants scheme, the PfD supported a Community Participation Strategy (CPS) project over a three year period. The project involved the rural areas of six Bolivian departments and suburban areas of three Bolivian cities. The main objective was to increase health service utilization with a particular emphasis on empowerment of women, strengthening of local organizations and increasing the demand for health services. Women from both the urban and rural areas, and from different indigenous groups, were trained in project management, health promotion, reproductive health and family planning, advocacy and community participation. Participatory methodologies have allowed empowering women in decision making and capacity building throughout the entire project process. The experience shows that it is important to work with formally established grass-root community organizations and strengthen leadership within them. Additionally, the sub-projects demonstrated that interventions are more successful when promoters speak and write native languages, women are more motivated and empowered, projects are designed to be responsive to daily necessities identified by the communities and health services are culturally suitable. A preliminary evaluation, in both quantitative and qualitative terms, shows an overall improvement in health knowledge and practice, and utilization of health services.

The utilization and management of plant resources in rural areas of the Limpopo Province, South Africa

PubMed Central

2013-01-01

Background Most rural people in the Limpopo Province depend on plant resources to meet their livelihood needs. However, there is insufficient recorded information regarding their use and management. The current study therefore was carried out in selected villages of the Limpopo Province, to close this knowledge gap. Methods Information was collected from 60 people residing in two villages, using a semi-structured questionnaire, supplemented with field observations. Results A total of 47 wild plant species (95% indigenous and 5% exotics) from 27 families, mostly from the Fabaceae (17%), Anacardiaceae (9%), and Combretaceae (9%) were documented. These species were used primarily for firewood (40%), food (36%) and medicine (29%). Significantly used species included Sclerocarya birrea (85%), Combretum kraussii (35%) and Harpephyllum caffrum (35%). Local traditional rules and regulations including taboos, social beliefs and fines are in place to aid in the management of communal resources. However, a significant number (67%) of participants mentioned that they were not pleased with these rules and regulations. Conclusion The current study concluded that plant resources still play an important role in the surveyed rural areas of the Limpopo Province. Furthermore, for sustainable utilization and long-term conservation of plants in these areas the government should assist communities in the management of their plant resources. PMID:23590903

7 CFR 1951.218 - Use of Rural Development loans and grants for other purposes.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE... Servicing of Community and Direct Business Programs Loans and Grants § 1951.218 Use of Rural Development... the Administrator of the Rural Housing Service or Rural Business-Cooperative Service that has the...

Federal Funding Sources for Rural Areas. Rural Information Center Publication Series, No. 49. Revised Edition.

ERIC Educational Resources Information Center

Reynnells, M. Louise, Comp.

This document lists 248 federal funding programs available to rural areas. The programs were selected from the Catalog of Federal Domestic Assistance, 1995, which is available online from the Federal Assistance Programs Retrieval System (FAPRS). Entries are listed under the following federal departments or agencies: Department of Agriculture,…

Examining the relationship between school district size and science achievement in Texas including rural school administrator perceptions of challenges and solutions

NASA Astrophysics Data System (ADS)

Mann, Matthew James

Rural and small schools have almost one-third of all public school enrollment in America, yet typically have the fewest financial and research based resources. Educational models have been developed with either the urban or suburban school in mind, and the rural school is often left with no other alternative except this paradigm. Rural based educational resources are rare and the ability to access these resources for rural school districts almost non-existent. Federal and state based education agencies provide some rural educational based programs, but have had virtually no success in answering rural school issues. With federal and state interest in science initiatives, the challenge that rural schools face weigh in. To align with that focus, this study examined Texas middle school student achievement in science and its relationship with school district enrollment size. This study involved a sequential transformative mixed methodology with the quantitative phase driving the second qualitative portion. The quantitative research was a non-experimental causal-comparative study conducted to determine whether there is a significant difference between student achievement on the 2010 Texas Assessment of Knowledge and Skills 8 th grade science results and school district enrollment size. The school districts were distributed into four categories by size including: a) small districts (32-550); b) medium districts (551-1500); c) large districts (1501-6000); and d) mega-sized districts (6001-202,773). A one-way analysis of variance (ANOVA) was conducted to compare the district averages from the 2010 TAKS 8th grade science assessment results and the four district enrollment groups. The second phase of the study was qualitative utilizing constructivism and critical theory to identify the issues facing rural and small school administrators concerning science based curriculum and development. These themes and issues were sought through a case study method and through use of semi

77 FR 44655 - FY 2012 Notice of Funding Availability (NOFA) for Rural Capacity Building Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... Availability (NOFA) for Rural Capacity Building Program AGENCY: Office of the Chief Information Officer, HUD... with Rural Capacity Building program will allow CPD to accurately assess the experience, expertise, and... order to ensure the eligibility of Rural Capacity Building program applicants and proposals, to rate and...

Plan of Work for Rural Development in North Carolina, July 1, 1975 - June 30, 1976.

ERIC Educational Resources Information Center

Hyatt, George, Jr.; And Others

Serving primarily as a policy group for local Rural Development Panels, the North Carolina Rural Development Committee's major objective for 1976 is to work with local leaders, private businesses and governmental agencies at all levels in planning and implementing comprehensive rural development programs. Specifically, the Committee's objectives…

Utilisation and costs of nursing agencies in the South African public health sector, 2005–2010

PubMed Central

Rispel, Laetitia C.; Angelides, George

2014-01-01

Background Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. Objective The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. Design A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6–2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Results Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape

Federal Funding Sources Available to Local Governments for Rural Areas. Rural Information Center Publication Series, No. 4.

ERIC Educational Resources Information Center

Reynnells, M. Louise, Comp.

This publication contains information on 101 federal programs that provide funding to rural projects initiated by local governments, public agencies, tribal governments, nonprofit organizations, educational institutions, citizen groups, and individuals. Eligible local project categories include conservation, farm ownership and operation, housing,…

The Rising Rate of Rural Hospital Closures.

PubMed

Kaufman, Brystana G; Thomas, Sharita R; Randolph, Randy K; Perry, Julie R; Thompson, Kristie W; Holmes, George M; Pink, George H

2016-01-01

Since 2010, the rate of rural hospital closures has increased significantly. This study is a preliminary look at recent closures and a formative step in research to understand the causes and the impact on rural communities. The 2009 financial performance and market characteristics of rural hospitals that closed from 2010 through 2014 were compared to rural hospitals that remained open during the same period, stratified by critical access hospitals (CAHs) and other rural hospitals (ORHs). Differences were tested using Pearson's chi-square (categorical variables) and Wilcoxon rank test of medians. The relationships between negative operating margin and (1) market factors and (2) utilization/staffing factors were explored using logistic regression. In 2009, CAHs that subsequently closed from 2010 through 2014 had, in general, lower levels of profitability, liquidity, equity, patient volume, and staffing. In addition, ORHs that closed had smaller market shares and operated in markets with smaller populations compared to ORHs that remained open. Odds of unprofitability were associated with both market and utilization factors. Although half of the closed hospitals ceased providing health services altogether, the remainder have since converted to an alternative health care delivery model. Financial and market characteristics appear to be associated with closure of rural hospitals from 2010 through 2014, suggesting that it is possible to identify hospitals at risk of closure. As closure rates show no sign of abating, it is important to study the drivers of distress in rural hospitals, as well as the potential for alternative health care delivery models. © 2015 National Rural Health Association.

Evaluating the accessibility and utility of HIV-related point-of-care diagnostics for maternal health in rural South Africa: a study protocol

PubMed Central

Mashamba-Thompson, T P; Drain, P K; Sartorius, B

2016-01-01

Introduction Poor healthcare access is a major barrier to receiving antenatal care and a cause of high maternal mortality in South Africa (SA). ‘Point-of-care’ (POC) diagnostics is a powerful emerging healthcare approach to improve healthcare access. This study focuses on evaluating the accessibility and utility of POC diagnostics for maternal health in rural SA primary healthcare (PHC) clinics in order to generate a model framework of implementation of POC diagnostics in rural South African clinics. Method and analyses We will use several research methods, including a systematic review, quasi-experiments, survey, key informant interviews and audits. We will conduct a systematic review and experimental study to determine the impact of POC diagnostics on maternal health. We will perform a cross-sectional case study of 100 randomly selected rural primary healthcare clinics in KwaZulu-Natal to measure the context and patterns of POC diagnostics access and usage by maternal health providers and patients. We will conduct interviews with relevant key stakeholders to determine the reasons for POC deficiencies regarding accessibility and utility of HIV-related POC diagnostics for maternal health. We will also conduct a vertical audit to investigate all the quality aspects of POC diagnostic services including diagnostic accuracy in a select number of clinics. On the basis of information gathered, we will propose a model framework for improved implementation of POC diagnostics in rural South African public healthcare clinics. Statistical (Stata-13) and thematic (NVIVO) data analysis will be used in this study. Ethics and dissemination The study protocol was approved by the Ethics Committee of the University of KwaZulu-Natal (BE 484/14) and the KwaZulu-Natal Department of Health based on the Helsinki Declaration (HRKM 40/15). Findings of this study will be disseminated electronically and in print. They will be presented to conferences related to HIV/AIDS, diagnostics

Ozone levels in European and USA cities are increasing more than at rural sites, while peak values are decreasing.

PubMed

Paoletti, Elena; De Marco, Alessandra; Beddows, David C S; Harrison, Roy M; Manning, William J

2014-09-01

Ground-level ozone (O3) levels are usually lower in urban centers than nearby rural sites. To compare trends in O3 levels during the period 1990-2010, we obtained monitoring data from paired urban and rural sites from the European Environment Agency and the US Environmental Protection Agency. Ozone peaks decreased at both station types, with no significant differences between urban and rural stations. Ozone annual averages increased at both urban and rural sites, with a faster rate of increase for urban centers. The overall trend was for convergence between urban and rural O3 data. Ozone levels exceeded the criteria established for the protection of human and vegetation health at both urban and rural sites. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does the Universal Health Insurance Program Affect Urban-Rural Differences in Health Service Utilization among the Elderly? Evidence from a Longitudinal Study in Taiwan

ERIC Educational Resources Information Center

Liao, Pei-An; Chang, Hung-Hao; Yang, Fang-An

2012-01-01

Purpose: To assess the impact of the introduction of Taiwan's National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. Methods: A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences…

77 FR 36996 - South Mississippi Electric Cooperative: Plant Ratcliff, Kemper County Integrated Gasification...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-20

... DEPARTMENT OF AGRICULTURE Rural Utilities Service South Mississippi Electric Cooperative: Plant Ratcliff, Kemper County Integrated Gasification Combined-Cycle (IGCC) Project AGENCY: Rural Utilities... Combined-Cycle (IGCC) Project currently under construction in Kemper County, Mississippi (hereinafter ``the...

7 CFR 1944.514 - Comprehensive TSA grant projects.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... growth or decline, the amount of inadequate housing, economic conditions, and trends of the rural areas...

7 CFR 1944.514 - Comprehensive TSA grant projects.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... growth or decline, the amount of inadequate housing, economic conditions, and trends of the rural areas...

7 CFR 4290.120 - Plan to invest in Rural Areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Applicant must agree that if licensed as a RBIC, it will make Developmental Venture Capital investments in... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ...

Mobile Versus Fixed Deployment of Automated External Defibrillators in Rural EMS.

PubMed

Nelson, R Darrell; Bozeman, William; Collins, Greg; Booe, Brian; Baker, Todd; Alson, Roy

2015-04-01

There is no consensus on where automated external defibrillators (AEDs) should be placed in rural communities to maximize impact on survival from cardiac arrest. In the community of Stokes County, North Carolina (USA) the Emergency Medical Services (EMS) system promotes cardiopulmonary resuscitation (CPR) public education and AED use with public access defibrillators (PADs) placed mainly in public schools, churches, and government buildings. This study tested the utilization of AEDs assigned to first responders (FRs) in their private-owned-vehicle (POV) compared to AEDs in fixed locations. The authors performed a prospective, observational study measuring utilization of AEDs carried by FRs in their POV compared to utilization of AEDs in fixed locations. Automated external defibrillator utilization is activation with pads placed on the patient and analysis of heart rhythm to determine if shock/no-shock is indicated. The Institutional Review Board of Wake Forest University Baptist Health System approved the study and written informed consent was waived. The study began on December 01, 2012 at midnight and ended on December 01, 2013 at midnight. During the 12-month study period, 81 community AEDs were in place, 66 in fixed locations and 15 assigned to FRs in their POVs. No utilizations of the 66 fixed location AEDs were reported (0.0 utilizations/AED/year) while 19 utilizations occurred in the FR POV AED study group (1.27 utilizations/AED/year; P<.0001). Odds ratio of using a FR POV located AED was 172 times more likely than using a community fixed-location AED in this rural community. Discussion Placing AEDs in a rural community poses many challenges for optimal utilization in terms of cardiac arrest occurrences. Few studies exist to direct rural community efforts in placing AEDs where they can be most effective, and it has been postulated that placing them directly with FRs may be advantageous. In this rural community, the authors found that placing AED devices with

Recouple: Natural Resource Strategies for Rural Economic Development.

ERIC Educational Resources Information Center

Thomas, Margaret G.

This source book provides guidance and technical assistance material on utilizing forest, agricultural, and scenic and wildlife resources for rural economic development. The document focuses on the uniqueness of existing rural resources for new enterprise opportunities. Natural resource-based economic development strategies are a means to…

Reproductive health service utilization and social determinants among married female rural-to-urban migrants in two metropolises, China.

PubMed

Liu, Zhi-Yong; Li, Jiang; Hong, Yang; Yao, Lan

2016-12-01

Reproductive health (RH) education and services of female migrants in China have become an important health issue. This research aimed to investigate the RH knowledge and utilization among married female migrants, and to explore the influencing factors from the perspectives of population and sociology. We conducted a cross-section survey in Shenzhen and Wuhan, China, using the purposive sampling method. A total of 1021 rural-to-urban married migrants were recruited, with 997 valid survey results obtained. A face-to-face structured questionnaire survey was used, with primary focus on knowledge of fertility, contraception, family planning policy and sexual transmitted diseases/acquired immunodeficiency syndrome (STD/AIDs), and RH service utilization. The results showed that the RH service utilization (38.0%) was at a low level in married migrants and the accessibility of RH service was poor. Females who migrated to (OR=0.32) Wuhan obtained fewer RH consultations than those in Shenzhen. The workers with high school education received additional RH consultations and checkup services than those with other background education, apart from the white collar workers who received extra RH consultations and checkup services than the blue collar workers (P<0.05). We can draw a conclusion that the utilization of RH services in married female migrants remains at a low level in China. RH service utilization can be improved via the relevant health departments by enhancing the responsibility of maternal and health care in the community health service center.

Utility of an Interactive Voice Response System to Assess Antiretroviral Pharmacotherapy Adherence Among Substance Users Living with HIV/AIDS in the Rural South

PubMed Central

Simpson, Cathy A.; Huang, Jin; Roth, David L.; Stewart, Katharine E.

2013-01-01

Abstract Promoting HIV medication adherence is basic to HIV/AIDS clinical care and reducing transmission risk and requires sound assessment of adherence and risk behaviors such as substance use that may interfere with adherence. The present study evaluated the utility of a telephone-based Interactive Voice Response self-monitoring (IVR SM) system to assess prospectively daily HIV medication adherence and its correlates among rural substance users living with HIV/AIDS. Community-dwelling patients (27 men, 17 women) recruited from a non-profit HIV medical clinic in rural Alabama reported daily medication adherence, substance use, and sexual practices for up to 10 weeks. Daily IVR reports of adherence were compared with short-term IVR-based recall reports over 4- and 7-day intervals. Daily IVR reports were positively correlated with both recall measures over matched intervals. However, 7-day recall yielded higher adherence claims compared to the more contemporaneous daily IVR and 4-day recall measures suggestive of a social desirability bias over the longer reporting period. Nearly one-third of participants (32%) reported adherence rates below the optimal rate of 95% (range=0–100%). Higher IVR-reported daily medication adherence was associated with lower baseline substance use, shorter duration of HIV/AIDS medical care, and higher IVR utilization. IVR SM appears to be a useful telehealth tool for monitoring medication adherence and identifying patients with suboptimal adherence between clinic visits and can help address geographic barriers to care among disadvantaged, rural adults living with HIV/AIDS. PMID:23651105

Catalyst for Interorganizational Collaboration: The Partnership for Rural Improvement. Working Paper Series.

ERIC Educational Resources Information Center

Loomis, Ralph A.; Spencer, Gregory P.

The Partnership for Rural Improvement (PRI) designs and tests methods of creating and strengthening cooperation among providers and between providers and users of rural public services. PRI has defined six types of collaboration (voluntary, involuntary, formal, informal, direct, and indirect) and strives for voluntary collaboration among agencies,…

7 CFR 1944.72 - Application packaging orientation and training.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Application packaging orientation and training. 1944... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... Grants § 1944.72 Application packaging orientation and training. Agency approval officials will orient...

7 CFR 4284.513 - Evaluation criteria and weights.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 4284.513 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GRANTS Rural Cooperative... Rural areas. (c) Economic development. The Agency will evaluate the applicant's demonstrated ability to...

7 CFR 4284.513 - Evaluation criteria and weights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 4284.513 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GRANTS Rural Cooperative... Rural areas. (c) Economic development. The Agency will evaluate the applicant's demonstrated ability to...

7 CFR 4284.513 - Evaluation criteria and weights.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 4284.513 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GRANTS Rural Cooperative... Rural areas. (c) Economic development. The Agency will evaluate the applicant's demonstrated ability to...

7 CFR 4284.513 - Evaluation criteria and weights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 4284.513 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GRANTS Rural Cooperative... Rural areas. (c) Economic development. The Agency will evaluate the applicant's demonstrated ability to...

77 FR 22347 - Agency Information Collection Agencies: Proposed Collection; Comments Requested Reinstatement...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-13

... of the functions of the agency, including whether the information will have practical utility; 2... eight waves of the BJS-sponsored surveys in the Law Enforcement Management and Administrative Statistics... vary from wave to wave. In addition to core issues concerning the number and type of agencies, the...

An evaluation of rural health care research.

PubMed

Kane, R; Dean, M; Solomon, M

1979-05-01

Reviews the state of the art of rural health research and evaluation in the U.S. with particular emphasis on the questions of access, health personnel, and financing. The current state of knowledge both in the published and unpublished literature in each area is summarized and a series of unresolved issues is proposed. A strategy for further research to include the various types of rural health care programs is described. Major findings suggest that, although rural populations do have somewhat less access to care than do urban populations, our ability to quantify precisely the extent and importance of this discrepancy is underdeveloped. Despite a substantial investment in a variety of rural health care programs there is inadequate information as to their effectiveness. Programs designed to increase the supply of health personnel to rural areas have met with mixed success. Sites staffed by National Health Service Corps personnel show consistently lower productivity than do sites under other sponsorship. Nonphysician personnel (physician assistants and nurse practitioners) offer a promising source of primary care for rural areas: recent legislation that reimburses such care should increase their utilization. A persistent problem is the expectation (often a mandate) incorporated into many rural health care demonstration efforts that the programs become financially self-sufficient in a finite period of time. Self-sufficiency is a function of utilization, productivity, and the ability to recover charges for services. In many instances stringent enforcement of the self-sufficiency requirement may mean those who need services most will be least likely to receive them.

76 FR 37779 - Rural Broadband Access Loans and Loan Guarantees Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-28

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Broadband Access Loans and Loan Guarantees... of $325,663,157 in loan funds for the Rural Broadband Access Loans and Loan Guarantees Program for... identifying a definite funding amount. The maximum amount of a loan under this authority will be $75 million...

Art Education and Rural Schools: Reflections from the Field. Country Teacher.

ERIC Educational Resources Information Center

Thurber, Frances E.

1997-01-01

An art education teacher-educator discusses the strengths and potential of rural education, arising from the sense of community found in small rural schools. Gives six suggestions to art teacher-educators concerning integrating art with other curricula, utilizing technology in art education, ensuring that rural students are afforded equal…

77 FR 14364 - Comment Sought on Funding Pilot Program Participants Transitioning Out of the Rural Health Care...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

... Program Participants Transitioning Out of the Rural Health Care Pilot Program in Funding Year 2012 AGENCY..., the Wireline Competition Bureau seeks comment on whether to fund Rural Health Care Pilot Program... transition them into the permanent Rural Health Care support mechanism (RHC support mechanism). DATES...

Telecommunications technology and rural education in the United States

NASA Technical Reports Server (NTRS)

Perrine, J. R.

1975-01-01

The rural sector of the US is examined from the point of view of whether telecommunications technology can augment the development of rural education. Migratory farm workers and American Indians were the target groups which were examined as examples of groups with special needs in rural areas. The general rural population and the target groups were examined to identify problems and to ascertain specific educational needs. Educational projects utilizing telecommunications technology in target group settings were discussed. Large scale regional ATS-6 satellite-based experimental educational telecommunications projects were described. Costs and organizational factors were also examined for large scale rural telecommunications projects.

Rural interstate corridor communications study : report to Congress.

DOT National Transportation Integrated Search

2007-08-28

"The United States Department of Transportation, working with the U.S. Department of Commerce and with State and local agencies, investigated the prospects for deploying high-speed telecommunications (HST) in three largely rural interstate highway co...

Rural interstate corridor communications study : report to Congress

DOT National Transportation Integrated Search

2007-08-28

The United States Department of Transportation, working with the U.S. Department of Commerce and with State and local agencies, investigated the prospects for deploying high-speed telecommunications (HST) in three largely rural interstate highway cor...

Negotiating Collective and Individual Agency

PubMed Central

Paul, Mandira; Essén, Birgitta; Sariola, Salla; Iyengar, Sharad; Soni, Sunita; Klingberg Allvin, Marie

2016-01-01

The societal changes in India and the available variety of reproductive health services call for evidence to inform health systems how to satisfy young women’s reproductive health needs. Inspired by Foucault’s power idiom and Bandura’s agency framework, we explore young women’s opportunities to practice reproductive agency in the context of collective social expectations. We carried out in-depth interviews with 19 young women in rural Rajasthan. Our findings highlight how changes in notions of agency across generations enable young women’s reproductive intentions and desires, and call for effective means of reproductive control. However, the taboo around sex without the intention to reproduce made contraceptive use unfeasible. Instead, abortions were the preferred method for reproductive control. In conclusion, safe abortion is key, along with the need to address the taboo around sex to enable use of “modern” contraception. This approach could prevent unintended pregnancies and expand young women’s agency. PMID:26531879

76 FR 17379 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Information Collection Activity; Comment Request... Service an agency delivering the U.S. Department of Agriculture (USDA) Rural Development Utilities... [email protected] . Title: Water and Waste Loan and Grant Program. Type of Request: Extension...

78 FR 40096 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Information Collection Activity; Comment Request AGENCY: Rural Utilities Service, USDA. ACTION: Notice and request for comments. SUMMARY: In accordance... Service (RUS) invites comments on this information collection for which approval from the Office of...

76 FR 20624 - Oglethorpe Power Corporation: Proposed Biomass Power Plant

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Oglethorpe Power Corporation: Proposed Biomass Power Plant AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Availability of a Draft...) biomass plant and related facilities (Proposal) in Warren County, Georgia. The purpose of the Proposal is...

7 CFR 1955.101 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM... will be handled in accordance with this Subpart.This subpart does not apply to Farm Service Agency, Farm Loan Programs, Single Family Housing (SFH) inventory property, or to the Rural Rental Housing...

7 CFR 1900.153 - Identifying and reporting an employee relationship.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY... Under Public Law 103-354 Assistance to Employees, Relatives, and Associates § 1900.153 Identifying and... its successor agency under Public Law 103-354 employee. The applicant is required to disclose the...

Receipt of Cancer Screening Services: Surprising Results for Some Rural Minorities

ERIC Educational Resources Information Center

Bennett, Kevin J.; Probst, Janice C.; Bellinger, Jessica D.

2012-01-01

Background: Evidence suggests that rural minority populations experience disparities in cancer screening, treatment, and outcomes. It is unknown how race/ethnicity and rurality intersect in these disparities. The purpose of this analysis is to examine the cancer screening rates among minorities in rural areas. Methods: We utilized the 2008…

41 CFR 101-39.301 - Utilization guidelines.

Code of Federal Regulations, 2011 CFR

2011-07-01

... § 101-39.301 Utilization guidelines. An agency must be able to justify a full-time vehicle assignment... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Utilization guidelines... System (IFMS) services. Other utilization factors, such as days used, agency mission, and the relative...

7 CFR 1942.306 - Purposes of grants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... importance to farmers and rural residents. (10) Create, expand, and operate rural distance learning networks or rural learning programs, that provide educational instruction or job training instruction related...-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED...

7 CFR 1942.306 - Purposes of grants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... importance to farmers and rural residents. (10) Create, expand, and operate rural distance learning networks or rural learning programs, that provide educational instruction or job training instruction related...-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED...

7 CFR 1942.306 - Purposes of grants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... importance to farmers and rural residents. (10) Create, expand, and operate rural distance learning networks or rural learning programs, that provide educational instruction or job training instruction related...-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED...

7 CFR 1942.306 - Purposes of grants.

Code of Federal Regulations, 2011 CFR

2011-01-01

...-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED... importance to farmers and rural residents. (10) Create, expand, and operate rural distance learning networks or rural learning programs, that provide educational instruction or job training instruction related...

7 CFR 1980.495 - FmHA or its successor agency under Public Law 103-354 forms and guides.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Disaster Assistance for Rural Business Enterprises” and Forms FmHA or its successor agency under Public Law 103-354 1980-71, “Lender's Agreement—Disaster Assistance for Rural Business Enterprises Guaranteed Loans,” 1980-72 “Loan Note Guarantee—Disaster Assistance for Rural Business Enterprises Guaranteed Loans...

TANK OPERATIONS CONTRACT CONSTRUCTION MANAGEMENT METHODOLOGY UTILIZING THE AGENCY METHOD OF CONSTRUCTION MANAGEMENT

DOE Office of Scientific and Technical Information (OSTI.GOV)

LESKO KF; BERRIOCHOA MV

2010-02-26

Washington River Protection Solutions, LLC (WRPS) has faced significant project management challenges in managing Davis-Bacon construction work that meets contractually required small business goals. The unique challenge is to provide contracting opportunities to multiple small business constructioin subcontractors while performing high hazard work in a safe and productive manner. Previous to the WRPS contract, construction work at the Hanford Tank Farms was contracted to large companies, while current Department of Energy (DOE) Contracts typically emphasize small business awards. As an integral part of Nuclear Project Management at Hanford Tank Farms, construction involves removal of old equipment and structures and installationmore » of new infrastructure to support waste retrieval and waste feed delivery to the Waste Treatment Plant. Utilizing the optimum construction approach ensures that the contractors responsible for this work are successful in meeting safety, quality, cost and schedule objectives while working in a very hazardous environment. This paper descirbes the successful transition from a traditional project delivery method that utilized a large business general contractor and subcontractors to a new project construction management model that is more oriented to small businesses. Construction has selected the Agency Construction Management Method (John E Schaufelberger, Len Holm, "Management of Construction Projects, A Constructor's Perspective", University of Washington, Prentice Hall 2002). This method was implemented in the first quarter of Fiscal Year 2009 (FY2009), where Construction Management is performed by substantially home office resources from the URS Northwest Office in Richland, Washington. The Agency Method has allowed WRPS to provide proven Construction Managers and Field Leads to mentor and direct small business contractors, thus providing expertise and assurance of a successful project. Construction execution contracts are

42 CFR 456.506 - Waiver options for Medicaid agency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers... options for Medicaid agency. (a) The agency may apply for a waiver at any time it has the procedures...

76 FR 78235 - Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Availability of a Draft Environmental Impact Statement and Notice of Public Hearings. SUMMARY: Notice is hereby...

77 FR 2268 - Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of intent to extend public comment period for a Draft Environmental Impact Statement. SUMMARY: Notice is...

7 CFR 1962.6 - Liens and assignments on chattel property.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Security § 1962.6 Liens and assignments on chattel property. (a) Chattel property not covered by Agency... borrower, a crop lien will be taken as additional security when the County Supervisor determines in...

7 CFR 1944.258 - Professional assessment committee.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... management or an agency in the community which provides assessment services and conforms to section 802(e)(3... CHSP participants, with respect to race, religion, color, sex, national origin, familial status or type...

7 CFR 1900.155 - Designating the processing/servicing official.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY... Under Public Law 103-354 Assistance to Employees, Relatives, and Associates § 1900.155 Designating the... FmHA or its successor agency under Public Law 103-354 official authorized to conduct the activity...

7 CFR 1944.662 - Eligibility of HPG assistance on rental properties or co-ops.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) HOUSING Housing... the HPG grantee. The dwelling must be located in a rural area and be in need of housing preservation...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1955.105 - Real property affected (CONACT).

Code of Federal Regulations, 2011 CFR

2011-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Recreation; EOC: Rural Renewal; Water Facility; Business and Industry (B&I); Rural Development Loan Fund... values and trend reports such as those available from the Economic Research Service or professional...

77 FR 62243 - Rural Health Network Development Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Rural Health Network Development Program AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of Non-competitive Replacement Award to Siloam Springs Regional Health Cooperative, Inc. SUMMARY...

Location and Lifestyle: The Comparative Explanatory Ability of Urbanism and Rurality

ERIC Educational Resources Information Center

Lowe, George D.; Peek, Charles W.

1974-01-01

The article focuses on 2 questions pivotal to the issue of rural-urban differences: 1) "Do attitudinal differences remain among the rural and urban residents independent of differences generated by other potent variables?"; and 2) "Will any increase in the predictive utility of rurality be generated by use of a composite definition (residence plus…

7 CFR 1924.11 - District Director's review of incomplete development.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS CONSTRUCTION AND REPAIR Planning and Performing Construction...

Federal Funding Sources for Rural Areas: Fiscal Year 1998. Rural Information Center Publications Series, No. 59. Revised Edition.

ERIC Educational Resources Information Center

Reynnells, M. Louise, Comp.

This publication lists 265 federal funding programs available to rural areas. The programs were selected from the Catalog of Federal Domestic Assistance, 1997, which is available online from FAPRS (the Federal Assistance Programs Retrieval System). Entries are listed under the following federal departments or agencies: Department of Agriculture,…

“Can community level interventions have an impact on equity and utilization of maternal health care” – Evidence from rural Bangladesh

PubMed Central

2013-01-01

Background Evidence from low and middle income countries (LMICs) suggests that maternal mortality is more prevalent among the poor whereas access to maternal health services is concentrated among the rich. In Bangladesh substantial inequities exist both in the use of facility-based basic obstetric care and for home births attended by skilled birth attendant. BRAC initiated an intervention on Improving Maternal, Neonatal, and Child Survival (IMNCS) in the rural areas of Bangladesh in 2008. One of the objectives of the intervention is to improve the utilization of maternal and child health care services among the poor. This study aimed to look at the impact of the intervention on utilization and also on equity of access to maternal health services. Methods A quasi-experimental pre-post comparison study was conducted in rural areas of five districts comprising three intervention (Gaibandha, Rangpur and Mymensingh) and two comparison districts (Netrokona and Naogaon). Data on health seeking behaviour for maternal health were collected from a repeated cross sectional household survey conducted in 2008 and 2010. Results Results show that the intervention appears to cause an increase in the utilization of antenatal care. The concentration index (CI) shows that this has become pro-poor over time (from CI: 0.30 to CI: 0.04) in the intervention areas. In contrast the use of ANC from medically trained providers has become pro-rich (from, CI: 0.18 to CI: 0.22). There was a significant increase in the utilisation of trained attendants for home delivery in the intervention areas compared to the comparison areas and the change was found to be pro-poor. Use of postnatal care cervices was also found to be pro-poor (from CI: 0.37 to CI: 0.14). Utilization of ANC services provided by medically trained provider did not improve in the intervention area. However, where the intervention had a positive effect on utilization it also seemed to have had a positive effect on equity

Evaluating the relationship between the driver and roadway to address rural intersection safety using the SHRP 2 naturalistic driving study data.

DOT National Transportation Integrated Search

2016-02-01

Rural intersections account for 30% of crashes in rural areas and 6% of all fatal crashes, representing a significant but poorly : understood safety problem. Transportation agencies have traditionally implemented countermeasures to address rural inte...

Problem Identification Survey Handbook for Parish Rural Development Committees.

ERIC Educational Resources Information Center

Koch, Kenneth A.

The Task Force on Resource Development of the Cooperative Extension Service, Louisiana State University, decided to utilize the leader identification technique as a means of assisting the parish rural development committees in the rural development process. The technique is a procedure to stimulate effective citizen participation to identify…

76 FR 21109 - Rural Energy for America Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-14

...The Rural Business-Cooperative Service (Agency) is establishing an interim rule for the Rural Energy for America Program (REAP), which is authorized under the Food, Conservation, and Energy Act of 2008. This interim rule modifies the existing grant and guaranteed loan program for renewable energy systems and energy efficiency improvements. In addition, it adds a grant program for feasibility studies for renewable energy systems and a grant program for energy audits and renewable energy development assistance, as provided in the Food, Conservation, and Energy Act of 2008.

7 CFR 1940.333 - Applicability to planning assistance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Applicability to planning assistance. 1940.333 Section..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... to planning assistance. The award of FmHA or its successor agency under Public Law 103-354 funds for...

75 FR 28778 - Broadband Initiatives Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-24

... DEPARTMENT OF AGRICULTURE Rural Utilities Service RIN 0572-ZA01 Broadband Initiatives Program AGENCY: Rural Utilities Service, Department of Agriculture. ACTION: Notice of Extension of filing Public... Initiatives Program (BIP), published in the Federal Register at 75 FR 3820 (January 22, 2010). Such technical...

7 CFR 1780.62 - Utility purchase contracts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Utility purchase contracts. 1780.62 Section 1780.62 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE LOANS AND GRANTS Planning, Designing, Bidding, Contracting...

7 CFR Exhibit H to Subpart A of... - Prohibition of Lead-Based Paints

Code of Federal Regulations, 2013 CFR

2013-01-01

... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... any institutional structure where persons reside, such as an orphanage, boarding school, dormitory...

7 CFR Exhibit H to Subpart A of... - Prohibition of Lead-Based Paints

Code of Federal Regulations, 2014 CFR

2014-01-01

... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... any institutional structure where persons reside, such as an orphanage, boarding school, dormitory...

7 CFR Exhibit H to Subpart A of... - Prohibition of Lead-Based Paints

Code of Federal Regulations, 2012 CFR

2012-01-01

... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... any institutional structure where persons reside, such as an orphanage, boarding school, dormitory...

The impact of different benefit packages of Medical Financial Assistance Scheme on health service utilization of poor population in rural China.

PubMed

Hao, Yanhua; Wu, Qunhong; Zhang, Zhenzhong; Gao, Lijun; Ning, Ning; Jiao, Mingli; Zakus, David

2010-06-17

Since 2003 and 2005, National Pilot Medical Financial Assistance Scheme (MFA) has been implemented in rural and urban areas of China to improve the poorest families' accessibility to health services. Local governments of the pilot areas formulated various benefit packages. Comparative evaluation research on the effect of different benefit packages is urgently needed to provide evidence for improving policy-making of MFA. This study was based on a MFA pilot project, which was one component of Health VIII Project conducted in rural China. This article aimed to compare difference in health services utilization of poor families between two benefit package project areas: H8 towns (package covering inpatient service, some designated preventive and curative health services but without out-patient service reimbursement in Health VIII Project,) and H8SP towns (package extending coverage of target population, covering out- patient services and reducing co-payment rate in Health VIII Supportive Project), and to find out major influencing factors on their services utilization. A cross-sectional survey was conducted in 2004, which used stratified cluster sampling method to select poor families who have been enrolled in MFA scheme in rural areas of ChongQing. All family members of the enrolled households were interviewed. 748 and 1129 respondents from two kinds of project towns participated in the survey. Among them, 625 and 869 respondents were included (age>/=15) in the analysis of this study. Two-level linear multilevel model and binomial regressions with a log link were used to assess influencing factors on different response variables measuring service utilization. In general, there was no statistical significance in physician visits and hospitalizations among all the respondents between the two kinds of benefit package towns. After adjusting for major confounding factors, poor families in H8SP towns had much higher frequency of MFA use (beta = 1.17) and less use of

Utility of local health registers in measuring perinatal mortality: A case study in rural Indonesia

PubMed Central

2011-01-01

Background Perinatal mortality is an important indicator of obstetric and newborn care services. Although the vast majority of global perinatal mortality is estimated to occur in developing countries, there is a critical paucity of reliable data at the local level to inform health policy, plan health care services, and monitor their impact. This paper explores the utility of information from village health registers to measure perinatal mortality at the sub district level in a rural area of Indonesia. Methods A retrospective pregnancy cohort for 2007 was constructed by triangulating data from antenatal care, birth, and newborn care registers in a sample of villages in three rural sub districts in Central Java, Indonesia. For each pregnancy, birth outcome and first week survival were traced and recorded from the different registers, as available. Additional local death records were consulted to verify perinatal mortality, or identify deaths not recorded in the health registers. Analyses were performed to assess data quality from registers, and measure perinatal mortality rates. Qualitative research was conducted to explore knowledge and practices of village midwives in register maintenance and reporting of perinatal mortality. Results Field activities were conducted in 23 villages, covering a total of 1759 deliveries that occurred in 2007. Perinatal mortality outcomes were 23 stillbirths and 15 early neonatal deaths, resulting in a perinatal mortality rate of 21.6 per 1000 live births in 2007. Stillbirth rates for the study population were about four times the rates reported in the routine Maternal and Child Health program information system. Inadequate awareness and supervision, and alternate workload were cited by local midwives as factors resulting in inconsistent data reporting. Conclusions Local maternal and child health registers are a useful source of information on perinatal mortality in rural Indonesia. Suitable training, supervision, and quality control

Utility of local health registers in measuring perinatal mortality: a case study in rural Indonesia.

PubMed

Burke, Leona; Suswardany, Dwi Linna; Michener, Keryl; Mazurki, Setiawaty; Adair, Timothy; Elmiyati, Catur; Rao, Chalapati

2011-03-17

Perinatal mortality is an important indicator of obstetric and newborn care services. Although the vast majority of global perinatal mortality is estimated to occur in developing countries, there is a critical paucity of reliable data at the local level to inform health policy, plan health care services, and monitor their impact. This paper explores the utility of information from village health registers to measure perinatal mortality at the sub district level in a rural area of Indonesia. A retrospective pregnancy cohort for 2007 was constructed by triangulating data from antenatal care, birth, and newborn care registers in a sample of villages in three rural sub districts in Central Java, Indonesia. For each pregnancy, birth outcome and first week survival were traced and recorded from the different registers, as available. Additional local death records were consulted to verify perinatal mortality, or identify deaths not recorded in the health registers. Analyses were performed to assess data quality from registers, and measure perinatal mortality rates. Qualitative research was conducted to explore knowledge and practices of village midwives in register maintenance and reporting of perinatal mortality. Field activities were conducted in 23 villages, covering a total of 1759 deliveries that occurred in 2007. Perinatal mortality outcomes were 23 stillbirths and 15 early neonatal deaths, resulting in a perinatal mortality rate of 21.6 per 1000 live births in 2007. Stillbirth rates for the study population were about four times the rates reported in the routine Maternal and Child Health program information system. Inadequate awareness and supervision, and alternate workload were cited by local midwives as factors resulting in inconsistent data reporting. Local maternal and child health registers are a useful source of information on perinatal mortality in rural Indonesia. Suitable training, supervision, and quality control, in conjunction with computerisation to

Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data.

PubMed

Zhou, Zhongliang; Gao, Jianmin; Xue, Qinxiang; Yang, Xiaowei; Yan, Ju'e

2009-07-01

To solve the problem of 'Kan bing nan, kan bing gui' (medical treatment is difficult to access and expensive), a Harvard-led research team implemented a community-based health insurance scheme known as Rural Mutual Health Care (RMHC) in Chinese rural areas from 2004 to 2006. Two major policies adopted by RMHC included insurance coverage of outpatient services (demand-side policy) and drug policy (supply-side policy). This paper focuses on the effects of these two policies on outpatient service utilization in Chinese village clinics. The data used in this study are from 3-year household follow-up surveys. A generalized negative binomial regression model and a Heckman selection model were constructed using panel data from 2005 to 2007. The results indicate that the price elasticities of demand for outpatient visits and per-visit outpatient expenses were -1.5 and -0.553, respectively. After implementing the supply-side policy, outpatient visits and per-visit outpatient expenses decreased by 94.7 and 55.9%, respectively, controlling for insurance coverage. These findings can be used to make recommendations to the Chinese government on improving the health care system.

The National Seminar on Rural Education (College Park, Maryland, May 29-31, 1979).

ERIC Educational Resources Information Center

Wallace, Judi

Representing over 72 different groups and agencies, 107 participants attended the May 29-31, 1979, National Seminar on Rural Education. Prior to the seminar, experts and practitioners in the fields of rural education and sociology were commissioned to produce 22 papers documenting, summarizing, and interpreting research and practice in 6 areas:…

A community survey on maternal and child health services utilization in rural Ethiopia.

PubMed

Materia, E; Mehari, W; Mele, A; Rosmini, F; Stazi, M A; Damen, H M; Basile, G; Miuccio, G; Ferrigno, L; Miozzo, A

1993-09-01

A household health interview survey on MCH services utilization was carried out in 22 villages of a rural district of Arsi region, Ethiopia, before the launching of an integrated MCH programme. Coverage of antenatal services was 26%, and 61% of the women who received antenatal care reported having had 3 or more visits. Antenatal care was positively associated with living within 10 km of the Health Centre. Twenty-eight percent of the mothers attended the under-5 clinic and most returned for 3 or more visits. In addition, 99% reported having breast-fed their last child but more than 25% started weaning only after the seventh month of age. Differences in practice of treating diarrhoea according to knowledge of ORS were found. Of the 33% of those with knowledge of ORS, almost 90% reported use of ORS for treating child's diarrhoea, showing a positive attitude towards modern health care. The proportion of women using family planning was 5%, with no difference found between Christians and Muslims. Results on EPI coverage validated data from routine reporting. Integration of MCH services including out-reach activities may increase access and coverage of MCH services.

Comparison of Health Service Utilization for Febrile Children Before and After Introduction of Malaria Rapid Diagnostic Tests and Artemisinin-Based Combination Therapy in Rural Papua New Guinea.

PubMed

Tsukahara, Takahiro; Sugahara, Takuma; Furusawa, Takuro; Hombhanje, Francis Wanak

2018-01-01

In Papua New Guinea (PNG), a malaria treatment policy using rapid diagnostic tests (RDTs) plus artemisinin-based combination therapy (ACT) was widely introduced to rural communities in 2012. The objectives of the study were to evaluate the effect of this RDT/ACT introduction to a rural PNG population on health service utilization and to compare factors associated with health service utilization before and after the RDT/ACT introduction. Household surveys with structured questionnaires were conducted before and after the introduction of RDT/ACT in a catchment area of a health center in East Sepik Province, PNG. We interviewed caregivers with children less than 15 years of age and collected data on fever episodes in the preceding 2 weeks. Using propensity score matching, febrile children before the introduction of RDT/ACT were matched to febrile children after the introduction. Then, the adjusted difference in the proportion of health service utilization [i.e., the average treatment effect (ATE) of the introduction of RDT/ACT on health service utilization] was estimated. We also employed a multilevel Poisson regression model to investigate factors influencing the use of health services. Of 4,690 children, 911 (19%) were reported to have a fever episode. The unadjusted proportion of health service utilization was 51.7 and 57.2% before and after the RDT/ACT introduction, respectively. After matching, no significant difference in the health service utilization was observed before and after the introduction of RDT/ACT (ATE: 0.063, 95% confidence interval -0.024 to 0.150). Multilevel regression analysis showed that the consistent factors associated with a higher utilization of health services were severe illness and being female. The utilization of health services was not significantly different before and after the introduction of RDT/ACT. Villagers may have neither sufficient informations on the new protocol nor high acceptance of RDT/ACT. The observed gender bias

Home Care Services and the Rural Elderly.

ERIC Educational Resources Information Center

Hayslip, Bert, Jr.; And Others

1980-01-01

Independent studies examined a needs v an agency perspective on home health care service needs within a rural county. Interviews with 299 elderly, aged 60-93, revealed there were substantial needs for home health care services and the desire for services varied with residence within the county. (Author)

Revisiting the Rural Superintendency: Rethinking Guiding Theories for Contemporary Practice

ERIC Educational Resources Information Center

McHenry-Sorber, Erin; Budge, Kathleen

2018-01-01

This conceptual article challenges researchers and practitioners to reconsider the utility of current constructs used to understand the rural school superintendency. We evaluate the rural leadership literature through two waves of scholarship: insider/outsider conceptions and place-conscious/critical place-conscious constructs. We assert critical…

Comparing Maternal Services Utilization and Expense Reimbursement before and after the Adjustment of the New Rural Cooperative Medical Scheme Policy in Rural China

PubMed Central

You, Hua; Gu, Hai; Ning, Weiqing; Zhou, Hua; Dong, Hengjin

2016-01-01

Background The New Rural Cooperative Medical Scheme (NCMS) includes a maternal care benefits package that is associated with increasing maternal health services. The local compensation policies have been frequently adjusted in recent years. This study examined the association between the NCMS maternal-services policy adjustment and expense reimbursement in Yuyao, China. Methods Two household surveys were conducted in Yuyao in 2008 and 2011 (before and after the NCMS policy adjustment, respectively). Local women (N = 154) who had delivery history in the past three years were recruited. A questionnaire was used to collect information about delivery history, maternal health services utilization (prenatal care, postnatal care, and the grade of delivery institutions), NCMS participation, and reimbursement status. Logistic regression analyses were used to predict the association between policy adjustment and maternal health utilization and the association between policy adjustment and out-of-pocket proportion. Next, t-tests and covariance analyses adjusting for household income were used to compare the out-of-pocket proportion between 2008 and 2011. Results Results revealed that compensation policy adjustment was associated with an increase in postnatal visits (adjusted OR = 3.32, p = 0.009) and the use of second level or above institutions for delivery (adjusted OR = 2.32, p = 0.03) among participants. In 2008, only 9.1% of pregnant women received reimbursement from the NCMS; however, this rate increased to 36.8% in 2011. After policy adjustment, there were no significant changes in the proportion of out-of-pocket expenses shared in delivery fee (F = 0.24, p = 0.63) and in household income (F = 0.46, p = 0.50). Conclusions Financial compensation increase improved maternal health services utilization; however, this effect was limited. Although the reimbursement rate was raised, the out-of-pocket proportion was not significant changed; therefore, the compensation design

7 CFR Exhibit C to Subpart B of... - Letter for Notifying Applicants, Lenders, Holders, and Borrowers of Adverse Decisions When Part...

Code of Federal Regulations, 2010 CFR

2010-01-01

... of Part 1900 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS GENERAL Adverse Decisions and Administrative Appeals Pt. 1900...

7 CFR 1962.3 - Authorities and responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

....3 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) PERSONAL PROPERTY Servicing and Liquidation of Chattel Security...

7 CFR 1962.3 - Authorities and responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

....3 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) PERSONAL PROPERTY Servicing and Liquidation of Chattel Security...

Is the National Registration website (Australian Health Practitioner Regulation Agency) effective in tracking Australian medical graduates' rural work?

PubMed

Playford, Denese; Power, Phoebe; Boothroyd, Alarna; Manickavasagar, Usha; Ng, Wen Qi; Riley, Geoff

2013-10-01

This study compared rural location identified through the National Registration (AHPRA) registry with location obtained through labour-intensive personal contact. Longitudinal cohort study with two methods to identify the work locations of medical graduates from The Rural Clinical School of Western Australia (RCSWA). Consenting alumni from the University of Western Australia and the University of Notre Dame Fremantle participating in RCSWA between 2002 and 2009 inclusive and available to contact in 2011. Percentage location matches between two contact methods. There was 80% agreement for principal suburb, 92% agreement for principal city and 94% agreement for principal state between RCSWA personal contact and the AHPRA registry. AHPRA identified nearly two times as many graduate locations. However, there was only 31% agreement for a rural placement location (of any length). In more detail, for year-long rural placement, personal contact was 88% concordant with AHPRA; work six months or more were less concordant (44% agreement); work less than six months were not concordant (4% agreement). AHPRA data matched RCSWA alumni data only for graduates in full-time rural work. Since medical alumni spend up to 10 years in pre-vocational and vocational training, which includes many rural options, personal contact was able to pick up the myriad of rural choices, whereas the AHPRA database was not sensitive enough to identify them. Until graduates have stably finished training, the optimal method to identify rural work is through personal contact but statistical correction for missing data needs to be considered. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Longitudinal rural clerkships: increased likelihood of more remote rural medical practice following graduation.

PubMed

Playford, Denese E; Nicholson, Asha; Riley, Geoffrey J; Puddey, Ian B

2015-03-21

Extended rural clerkships clearly increase the likelihood of rural practice post-graduation. What has not been determined is whether such rural interventions increase the likelihood of graduates practicing in more remote, versus inner regional, locations. The Australian Health Practitioner Regulation Agency database was used to identify the current workplace of every graduate of the Medical School of Western Australia, 1980 to 2011. There were 324 graduates working in a primary practice location defined by the Australian Standard Geographical Classification as inner regional to very remote. They were divided into 3 groups - 200 graduates who entered medical school before commencement of the Rural Clinical School of Western Australia (RCSWA), 63 who entered after the RCSWA had started, but not participated in RCSWA, and 61 who participated in the RCSWA. The RCSWA offers a longitudinal rural clinical clerkship throughout level 5 of the MBBS course. The two groups not participating in the RCSWA had 45.5% and 52.4% of subjects in outer regional/very remote locations, respectively. In comparison, 78.7% of those who had participated in the RCSWA were currently practicing in outer regional/very remote locations. When the 3 groups were compared, the significant predictors of working in a more remote practice compared to working in an inner regional area were being female (OR 1.75 95% CI 1.13, 2.72, P = 0.013) and participating in the RCSWA (OR 4.42, 95% CI 2.26, 8.67, P < 0.001). In multivariate logistic regression that corrected for gender and remoteness of rural address before entry to medical school, participation in the RCSWA still predicted a more than 4-fold increase in the odds of practicing in a more remote area (OR 4.11, 95% CI 2.04, 8.30, P < 0.001). Extended rural clinical clerkship during an undergraduate MBBS course is related to a much greater likelihood of practicing in more remote, under-serviced rural locations.

7 CFR 2.17 - Under Secretary for Rural Development.

Code of Federal Regulations, 2012 CFR

2012-01-01

... economic, social, and environmental research and analysis, statistical programs, and associated service...; rural population and manpower; local government finance; income development strategies; housing; social... activities. (12) Assist other Federal agencies in formulating manpower development and training policies. (13...

7 CFR 2.17 - Under Secretary for Rural Development.

Code of Federal Regulations, 2011 CFR

2011-01-01

... economic, social, and environmental research and analysis, statistical programs, and associated service...; rural population and manpower; local government finance; income development strategies; housing; social... activities. (12) Assist other Federal agencies in formulating manpower development and training policies. (13...

7 CFR Exhibit F to Subpart G of... - Implementation Procedures for the Coastal Barrier Resources Act

Code of Federal Regulations, 2011 CFR

2011-01-01

... (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL... distributed by the Department of the Interior. Each State Director is responsible for ensuring that those...

7 CFR Exhibit F to Subpart G of... - Implementation Procedures for the Coastal Barrier Resources Act

Code of Federal Regulations, 2010 CFR

2010-01-01

... (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL... distributed by the Department of the Interior. Each State Director is responsible for ensuring that those...

7 CFR 1955.60 - Inventory property subject to redemption by the borrower.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) PROPERTY MANAGEMENT Management of Property § 1955.60 Inventory property subject to redemption by the borrower. If inventory...

Mental health literacy in rural Queensland: results of a community survey.

PubMed

Bartlett, Helen; Travers, Catherine; Cartwright, Colleen; Smith, Norman

2006-09-01

The aim of this study was to assess the awareness of, and attitudes to, mental health issues in rural dwelling Queensland residents. A secondary objective was to provide baseline data of mental health literacy prior to the implementation of Australian Integrated Mental Health Initiative--a health promotion strategy aimed at improving the health outcomes of people with chronic or recurring mental disorders. In 2004 a random sample of 2% (2132) of the estimated adult population in each of eight towns in rural Queensland was sent a postal survey and invited to participate in the project. A series of questions were asked based on a vignette describing a person suffering major depression. In addition, questions assessed respondents' awareness and perceptions of community mental health agencies. Approximately one-third (36%) of those surveyed completed and returned the questionnaire. While a higher proportion of respondents (81%) correctly identified and labelled the problem in the vignette as depression than previously reported in Australian community surveys, the majority of respondents (66%) underestimated the prevalence of mental health problems in the community. Furthermore, a substantial number of respondents (37%) were unaware of agencies in their community to assist people with mental health issues while a majority of respondents (57.6%) considered that the services offered by those agencies were poor. While mental health literacy in rural Queensland appears to be comparable to other Australian regions, several gaps in knowledge were identified. This is in spite of recent widespread coverage of depression in the media and thus, there is a continuing need for mental health education in rural Queensland.

7 CFR Exhibit C to Subpart G of... - Implementation Procedures for the Farmland Protection Policy Act; Executive Order 11988...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM... government, and private programs and policies to protect farmland. The Soil Conservation Service (SCS), as...

7 CFR 1980.471 - Liquidation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM... the cost of liquidation exceeds the potential recovery value of the collection. Whenever this occurs...

7 CFR 1942.303 - Authorities, delegation, and redelegation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) ASSOCIATIONS Rural Business Enterprise... Public Law 103-354 employees. Grant approval authorities are contained in subpart A of part 1901 of this...

7 CFR Exhibit D to Subpart B of... - Hearings/Review Officer Designations

Code of Federal Regulations, 2010 CFR

2010-01-01

... Subpart B of Part 1900 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS GENERAL Adverse Decisions and Administrative Appeals Pt. 1900...

7 CFR 1944.71 - Term of grant.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM... may be submitted after the annual housing application packaging orientation and training is held. The...

7 CFR 1900.154 - Determining the need for special handling.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... Under Public Law 103-354 Assistance to Employees, Relatives, and Associates § 1900.154 Determining the...

29 CFR 515.3 - Qualifications of the State agency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... UTILIZATION OF STATE AGENCIES FOR INVESTIGATIONS AND INSPECTIONS § 515.3 Qualifications of the State agency... be under the direction of an executive who gives full time to the work of the agency. The agency...

Patient Portal Utilization Among Ethnically Diverse Low Income Older Adults: Observational Study

PubMed Central

Quandt, Sara A; Sandberg, Joanne C; Miller Jr, David P; Latulipe, Celine; Leng, Xiaoyan; Talton, Jenifer W; Melius, Kathryn P; Smith, Alden; Bertoni, Alain G

2017-01-01

Background Patient portals can improve patient communication with providers, provide patients with greater health information access, and help improve patient decision making, if they are used. Because research on factors facilitating and limiting patient portal utilization has not been conceptually based, no leverage points have been indicated for improving utilization. Objective The primary objective for this analysis was to use a conceptual framework to determine potentially modifiable factors affecting patient portal utilization by older adults (aged 55 years and older) who receive care at clinics that serve low income and ethnically diverse communities. The secondary objective was to delineate how patient portal utilization is associated with perceived usefulness and usability. Methods Patients from one urban and two rural clinics serving low income patients were recruited and completed interviewer-administered questionnaires on patient portal utilization. Results A total of 200 ethnically diverse patients completed questionnaires, of which 41 (20.5%) patients reported utilizing portals. Education, social support, and frequent Internet utilization improve the odds of patient portal utilization; receiving health care at a rural clinic decreases the odds of portal utilization. Conclusions Leverage points to address disparities in patient portal utilization include providing training for older adults in patient portal utilization, involving spouses or other care partners in this training, and making information technology access available at public places in rural and urban communities. PMID:29138129

Responses to prospective payment by rural New Mexico hospitals.

PubMed

Smith, H L; Piland, N F; Phillipp, A M

1991-12-01

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed.

Responses to prospective payment by rural New Mexico hospitals.

PubMed Central

Smith, H L; Piland, N F; Phillipp, A M

1991-01-01

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed. PMID:1743969

Mortality and Revascularization following Admission for Acute Myocardial Infarction: Implication for Rural Veterans

ERIC Educational Resources Information Center

Abrams, Thad E.; Vaughan-Sarrazin, Mary; Kaboli, Peter J.

2010-01-01

Introduction: Annually, over 3,000 rural veterans are admitted to Veterans Health Administration (VA) hospitals for acute myocardial infarction (AMI), yet no studies of AMI have utilized the VA rural definition. Methods: This retrospective cohort study identified 15,870 patients admitted for AMI to all VA hospitals. Rural residence was identified…

Hamilton County: A Rural School District Profile.

ERIC Educational Resources Information Center

Harned, Catherine

Using state education agency, census, industry employment and occupational information data, this paper provides a detailed picture of a rural school district in Southern Illinois. Mining and agriculture are the major industries in Hamilton County. The major mining employer closed in February 1988, and the drought of 1988 is likely to adversely…

Microgrid Utilities for Rural Electrification in East Africa: Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Williams, Nathaniel J.

Expanding access to electricity is central to development in East Africa but massive increases in investment are required to achieve universal access. Private sector participation in electrification is essential to meeting electricity access targets. Policy makers have acknowledged that grid extension in many remote rural areas is not as cost effective as decentralized alternatives such as microgrids. Microgrid companies have been unable to scale beyond pilot projects due in part to challenges in raising capital for a business model that is perceived to be risky. This thesis aims to identify and quantify the primary sources of investment risk in microgrid utilities and study ways to mitigate these risks to make these businesses more viable. Two modeling tools have been developed to this end. The Stochastic Techno-Economic Microgrid Model (STEMM) models the technical and financial performance of microgrid utilities using uncertain and dynamic inputs to permit explicit modeling of financial risk. This model is applied in an investment risk assessment and case study in Rwanda. Key findings suggest that the most important drivers of risk are fuel prices, foreign exchange rates, demand for electricity, and price elasticity of demand for electricity. The relative importance of these factors is technology dependent with demand uncertainty figuring stronger for solar and high solar penetration hybrid systems and fuel prices driving risk in diesel power and low solar penetration hybrid systems. Considering uncertainty in system sizing presents a tradeoff whereby a decrease in expected equity return decreases downside risk. High solar penetration systems are also found to be more attractive to lenders. The second modeling tool leverages electricity consumption and demographic data from four microgrids in Tanzania to forecast demand for electricity in newly electrified communities. Using statistical learning techniques, improvements in prediction performance was achieved over

7 CFR 25.101 - Data utilized for eligibility determinations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 1 2014-01-01 2014-01-01 false Data utilized for eligibility determinations. 25.101 Section 25.101 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE... statistics on boundaries. The boundary of a rural area nominated for designation as an Empowerment Zone or...

7 CFR 25.101 - Data utilized for eligibility determinations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 1 2012-01-01 2012-01-01 false Data utilized for eligibility determinations. 25.101 Section 25.101 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE... statistics on boundaries. The boundary of a rural area nominated for designation as an Empowerment Zone or...

7 CFR 25.101 - Data utilized for eligibility determinations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 1 2013-01-01 2013-01-01 false Data utilized for eligibility determinations. 25.101 Section 25.101 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE... statistics on boundaries. The boundary of a rural area nominated for designation as an Empowerment Zone or...

7 CFR 25.101 - Data utilized for eligibility determinations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Data utilized for eligibility determinations. 25.101 Section 25.101 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE... statistics on boundaries. The boundary of a rural area nominated for designation as an Empowerment Zone or...

7 CFR 25.101 - Data utilized for eligibility determinations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 1 2011-01-01 2011-01-01 false Data utilized for eligibility determinations. 25.101 Section 25.101 Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE... statistics on boundaries. The boundary of a rural area nominated for designation as an Empowerment Zone or...

Program Integration: An Alternative for Improving County Rural Human Services Delivery. Technical Paper No. 13.

ERIC Educational Resources Information Center

Center for Rural Pennsylvania, Harrisburg.

This report examines program integration as a way to improve the delivery of rural human services in Pennsylvania. A panel of policymakers, human services providers, and representatives of state agencies identified barriers to effective rural human services delivery and generated policy recommendations. Most county-based human services in…

7 CFR 1944.70 - Targeting of HAPG funds to States.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... colonias. The number of applications will be published in the advertisement required under § 1944.72 of...

Alcohol and Other Drug Resistance Strategies Employed by Rural Adolescents

ERIC Educational Resources Information Center

Pettigrew, Jonathan; Miller-Day, Michelle; Krieger, Janice; Hecht, Michael L.

2011-01-01

This study seeks to identify how rural adolescents make health decisions and utilize communication strategies to resist influence attempts in offers of alcohol, tobacco, and other drugs (ATOD). Semi-structured interviews were conducted with 113 adolescents from rural school districts to solicit information on ATOD norms, past ATOD experiences, and…

Decentralizing Maternity Services to Increase Skilled Attendance at Birth and Antenatal Care Utilization in Rural Rwanda: A Prospective Cohort Study

PubMed Central

Nathan, Lisa M.; Shi, Quihu; Plewniak, Kari; Zhang, Charles; Nsabimana, Damien; Sklar, Marc; Mutimura, Eugene; Merkatz, Irwin R.; Einstein, Mark H.; Anastos, Kathryn

2015-01-01

To evaluate the effectiveness of decentralizing ambulatory reproductive and intrapartum services to increase rates of antenatal care (ANC) utilization and skilled attendance at birth (SAB) in Rwanda. A prospective cohort study was implemented with one control and two intervention sites: decentralized ambulatory reproductive healthcare and decentralized intrapartum care. Multivariate logistic regression analysis was performed with primary outcome of lack of SAB and secondary outcome of ≥3 ANC visits. 536 women were entered in the study. Distance lived from delivery site significantly predicted SAB (p = 0.007), however distance lived to ANC site did not predict ≥3 ANC visits (p = 0.81). Neither decentralization of ambulatory reproductive healthcare (p = 0.10) nor intrapartum care (p = 0.40) was significantly associated with SAB. The control site had the greatest percentage of women receive ≥3 ANC visits (p < 0.001). Receiving <3 ANC visits was associated with a 3.98 times greater odds of not having SAB (p = 0.001). No increase in adverse outcomes was found with decentralization of ambulatory reproductive health care or intrapartum care. The factors that predict utilization of physically accessible services in rural Africa are complex. Decentralization of services may be one strategy to increase rates of SAB and ANC utilization, but selection biases may have precluded accurate analysis. Efforts to increase ANC utilization may be a worthwhile investment to increase SAB. PMID:25652061

76 FR 80729 - Intergovernmental Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... Rural Utilities Service 7 CFR Part 4274 Intergovernmental Review AGENCIES: Rural Housing Service, Rural... reference to RD Instruction 1940-J, Intergovernmental Review.'' This action is necessary since the affected... offices have current guidance on intergovernmental review of proposed projects being reviewed pursuant to...

7 CFR 1942.107 - Priorities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 13 2011-01-01 2009-01-01 true Priorities. 1942.107 Section 1942.107 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM...

7 CFR 1942.107 - Priorities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 13 2014-01-01 2013-01-01 true Priorities. 1942.107 Section 1942.107 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM...

7 CFR 1942.107 - Priorities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 13 2012-01-01 2012-01-01 false Priorities. 1942.107 Section 1942.107 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM...

7 CFR 1806.21 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false General. 1806.21 Section 1806.21 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS...

7 CFR 1955.105 - Real property affected (CONACT).

Code of Federal Regulations, 2010 CFR

2010-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Recreation; EOC: Rural Renewal; Water Facility; Business and Industry (B&I); Rural Development Loan Fund... values and trend reports such as those available from the Economic Research Service or professional...

41 CFR 101-39.301 - Utilization guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Utilization guidelines... § 101-39.301 Utilization guidelines. An agency must be able to justify a full-time vehicle assignment. The following guidelines may be employed by an agency requesting GSA Interagency Fleet Management...

Becoming a Migrant: Aspirations of Youths during Their Transition to Adulthood in Rural Mexico

ERIC Educational Resources Information Center

Azaola, Marta Cristina

2012-01-01

This article explores young people's transitions to adulthood in a rural community in Mexico. The focus is on participants' migration experiences and the premise is that migration can be understood as an alternative way of inclusion found by the rural youth which is strongly determined by individuals' agency. The article explores the role played…

7 CFR 1806.4 - Examining and general servicing of insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... property which already has been made, or when the County Supervisor learns that any such transfer has been...

7 CFR 1806.4 - Examining and general servicing of insurance.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... property which already has been made, or when the County Supervisor learns that any such transfer has been...

7 CFR 1902.2 - Policies concerning disbursement of funds.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... help the borrower learn to properly manage his/her finances. Such a period will not exceed 1 year...

Reaching Rural Women: Case Studies and Strategies.

ERIC Educational Resources Information Center

Colle, Royal D.; Fernandez de Colle, Susana

Although not often considered in the past by planners because their economic contributions are not performed for money, rural women are contributors to the development of their countries. The urgency of reaching women with important information to break the cycle of poverty is now being recognized by the major development agencies. While there are…

Service in the snow. Maintaining care in rural California.

PubMed

Elliott, P

1993-08-01

The amount of snow that falls in the Sierras is proof that all is not sunshine in rural northeastern California. Isolation and road closures were just two of the challenges that one home care agency was able to surmount with careful planning.

76 FR 43604 - Pipeline Safety: Applying Safety Regulations to All Rural Onshore Hazardous Liquid Low-Stress...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-21

... Regulations to All Rural Onshore Hazardous Liquid Low-Stress Lines, Correction AGENCY: Pipeline and Hazardous... the Federal Pipeline Safety Regulations to address rural low-stress hazardous liquid pipelines that... regarding the compliance date for identifying all segments of a Category 3 low-stress pipeline. DATES: This...

Training and experience of nurses in responding to alcohol misuse in rural communities.

PubMed

Kennedy, Alison J; Mellor, David; McCabe, Marita P; Ricciardelli, Lina A; Brumby, Susan A; Head, Alexandra; Mercer-Grant, Catherine

2013-07-01

Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP). Qualitative interviews of 15 rural and remote nurses. Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP-an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse. Nurses found the training provided new-or built on existing-knowledge of alcohol misuse and offered practical hands-on "real life" skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended. The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice. © 2013 Wiley Periodicals, Inc.

7 CFR 1944.535 - Cancellation of an approved grant.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... Public Law 103-354 Appeal Procedure contained in subpart B of part 1900 of this chapter. [44 FR 36891...

7 CFR 1944.538 - Extending and revising grant agreements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... writing of the decision and advise the applicant of the appeal procedures under subpart B of part 1900 of...

Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors.

PubMed

Ngugi, Anthony K; Agoi, Felix; Mahoney, Megan R; Lakhani, Amyn; Mang'ong'o, David; Nderitu, Esther; Armstrong, Robert; Macfarlane, Sarah

2017-01-01

Knowledge of utilization of health services and associated factors is important in planning and delivery of interventions to improve health services coverage. We determined the prevalence and factors associated with health services utilization in a rural area of Kenya. Our findings inform the local health management in development of appropriately targeted interventions. We used a cluster sample survey design and interviewed household key informants on history of illness for household members and health services utilization in the preceding month. We estimated prevalence and performed random effects logistic regression to determine the influence of individual and household level factors on decisions to utilize health services. 1230/6,440 (19.1%, 95% CI: 18.3%-20.2%) household members reported an illness. Of these, 76.7% (95% CI: 74.2%-79.0%) sought healthcare in a health facility. The majority (94%) of the respondents visited dispensary-level facilities and only 60.1% attended facilities within the study sub-counties. Of those that did not seek health services, 43% self-medicated by buying non-prescription drugs, 20% thought health services were too costly, and 10% indicated that the sickness was not serious enough to necessitate visiting a health facility. In the multivariate analyses, relationship to head of household was associated with utilization of health services. Relatives other than the nuclear family of the head of household were five times less likely to seek medical help (Odds Ratio 0.21 (95% CI: 0.05-0.87)). Dispensary level health facilities are the most commonly used by members of this community, and relations at the level of the household influence utilization of health services during an illness. These data enrich the perspective of the local health management to better plan the allocation of healthcare resources according to need and demand. The findings will also contribute in the development of community-level health coverage interventions that

77 FR 46987 - Utility Allowances Submetering

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-07

... Utility Allowances Submetering AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... amend the utility allowance regulations concerning the low-income housing tax credit. The proposed regulations update the utility allowance regulations to clarify that utility costs paid by a tenant based on...

7 CFR 1980.472 - Protective advances.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED... liquidation is contemplated or in process. A precise rule of when a protective advance should be made is...

7 CFR 1927.58 - Closing the transaction.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM... other necessary parties to arrange the time and place of closing. The transaction may be closed when the...

7 CFR 1927.58 - Closing the transaction.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM... other necessary parties to arrange the time and place of closing. The transaction may be closed when the...

7 CFR 1924.102 - General policy.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false General policy. 1924.102 Section 1924.102 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS...

7 CFR 1924.102 - General policy.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false General policy. 1924.102 Section 1924.102 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS...

7 CFR 1924.102 - General policy.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false General policy. 1924.102 Section 1924.102 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS...

7 CFR 1924.102 - General policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false General policy. 1924.102 Section 1924.102 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS...

7 CFR 1924.102 - General policy.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true General policy. 1924.102 Section 1924.102 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS...

7 CFR 1822.262 - Objective.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Objective. 1822.262 Section 1822.262 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS...

7 CFR 1806.22 - Areas of responsibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Areas of responsibility. 1806.22 Section 1806.22 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE GENERAL...

7 CFR 1900.3 - State, district, and county office employees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false State, district, and county office employees. 1900.3 Section 1900.3 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF...

7 CFR 1900.54 - Effect on assistance pending appeal.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Effect on assistance pending appeal. 1900.54 Section 1900.54 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF...

77 FR 72814 - Information Collection; Secure Rural Schools Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... DEPARTMENT OF AGRICULTURE Forest Service Information Collection; Secure Rural Schools Act AGENCY: Forest Service, USDA. ACTION: Notice; request for comment. SUMMARY: In accordance with the Paperwork Reduction Act of 1995, this notice announces the intention of the Forest Service to seek approval to renew...

Inequity of Human Services: The Rural Tennessee Dilemma.

ERIC Educational Resources Information Center

Tennessee State Univ., Nashville.

Davidson, Williamson, Rutherford, and Cheatham counties of Tennessee were the setting for a study that sought to determine the types of health and social services provided to residents of rural areas and to assess the present status of the service delivery system. Interviews with both agency representatives and randomly selected household…

A Closer Look at Rural-Urban Health Disparities: Associations Between Obesity and Rurality Vary by Geospatial and Sociodemographic Factors.

PubMed

Cohen, Steven A; Cook, Sarah K; Kelley, Lauren; Foutz, Julia D; Sando, Trisha A

2017-04-01

Obesity affects over one-third of older adults in the United States. Both aging and obesity contribute to an increased risk for chronic disease, early mortality, and additional health care utilization. Obesity rates are higher in rural areas than in urban areas, although findings are mixed. The objectives of this study are to assess potential nonlinearity in the association between rurality and obesity, and to evaluate the potential for socioeconomic status and geographic area to moderate the associations between rurality and obesity. Using a representative sample of adults aged 65 and above from the Behavioral Risk Factor Surveillance System, obesity (BMI ≥ 30 kg/m 2 ) was modeled against the primary exposure of rural-urban status, as measured by the Index of Relative Rurality. Binary logistic regression models were used to estimate the odds of obesity by rurality both as a continuous variable and by decile of rurality. Models were then stratified by per-capita income and state to assess potential moderation by these factors. The prevalence of obesity in older adults was highest in intermediate rurality areas (OR in rurality decile #5 1.134, 95% CI: 1.086-1.184) and lowest in the most rural and most urban areas. Obesity was highest in low- and middle-income areas, regardless of rural-urban status. In high-income areas, obesity among older adults was highest in areas of intermediate rurality and lowest in the most rural areas (OR 0.726, 95% CI: 0.606-0.870) and more urban areas, showing a J-shaped association. There were substantial differences in the associations between rurality and obesity in older adults among states. Associations between rurality and obesity varied by degree of rurality, socioeconomic status, and geography. Therefore, traditional "one-size-fits-all" approaches to reducing rural-urban health disparities in older adults may be more effective if tailored to the area-specific rural-urban gradients in health. © 2016 National Rural Health

Rurality and Resilience in Education: Place-Based Partnerships and Agency to Moderate Time and Space Constraints

ERIC Educational Resources Information Center

Ebersohn, Liesel; Ferreira, Ronel

2012-01-01

In an ongoing longitudinal intervention study (STAR) we found that, although similarities existed in the way teachers promoted resilience, rural schools (in comparison to other STAR case schools) took longer to implement strategies to buoy support and found it difficult to sustain such support. Using rurality we wanted to understand how forces,…

7 CFR 1980.341 - Inspections of construction and compliance reviews.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY... subpart A of part 1924. (c) Water and water/waste disposal. The Lender will see that the water and water...

7 CFR 1980.341 - Inspections of construction and compliance reviews.

Code of Federal Regulations, 2011 CFR

2011-01-01

... HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY... subpart A of part 1924. (c) Water and water/waste disposal. The Lender will see that the water and water...

7 CFR 1962.18 - Unapproved disposition of chattel security.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... learns that a borrower has made a disposition of chattel security in a manner not provided for on Form Fm...

7 CFR 1962.18 - Unapproved disposition of chattel security.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF... learns that a borrower has made a disposition of chattel security in a manner not provided for on Form Fm...

Utilization of travel reimbursement in the Veterans Health Administration.

PubMed

Nelson, Richard E; Hicken, Bret; Cai, Beilei; Dahal, Arati; West, Alan; Rupper, Randall

2014-01-01

To improve access to care, the Veterans Health Administration (VHA) increased its patient travel reimbursement rate from 11 to 28.5 cents per mile on February 1, 2008, and again to 41.5 cents per mile on November 17, 2008. We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit. We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases. Because of our data's longitudinal nature, we used multivariable generalized estimating equation models for analysis. Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Our cohort contained 214,376 veterans. During the study period, the average number of reimbursements per veteran was higher for rural patients compared to urban patients, and for those living 50-75 miles from the nearest VHA facility compared to those living closer. Higher reimbursement rates led to more veterans obtaining reimbursement regardless of urban-rural residence or distance traveled to the nearest VHA facility. However, after the rate increases, urban veterans and veterans living <50 miles from the nearest VHA facility increased their travel reimbursement utilization slightly more than other patients. Our findings suggest an inverted U-shaped relationship between veterans' utilization of the VHA travel reimbursement benefit and travel distance. Both urban and rural veterans responded in roughly equal manner to changes to this benefit. © 2013 National Rural Health Association.

Renewable Energy for Rural Health Clinics (Energia Removable para Centros de Salud Rurales)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jimenez, A. C.; Olson, K.

This guide provides a broad understanding of the technical, social, and organizational aspects of health clinic electrification, especially through the use of renewable energy sources. It is intended to be used primarily by decision makers within governments or private agencies to accurately assess their health clinic's needs, select appropriate and cost-effective technologies to meet those needs, and to put into place effective infrastructure to install and maintain the hardware. This is the first in a series of rural applications guidebooks that the National Renewable Energy Laboratory (NREL) Village Power Program is commissioning to couple commercial renewable systems with rural applications.more » The guidebooks are complemented by NREL's Village Power Program's development activities, international pilot projects, and visiting professionals program. For more information on the NREL Village Power Program, visit the Renewables for Sustainable Village Power web site at http://www.rsvp.nrel .gov/rsvp/.« less

7 CFR Exhibit C to Subpart E of... - FmHA or Its Successor Agency Under Public Law 103-354 Financed Contract

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE...: Address: Telephone Number: Employer's Identification Number: 2. Contract for: __ $_____ Starting Date...

Community Partnerships, Food Pantries, and an Evidence-Based Intervention to Increase Mammography among Rural Women

ERIC Educational Resources Information Center

Bencivenga, Marcyann; DeRubis, Susan; Leach, Patricia; Lotito, Lisa; Shoemaker, Charles; Lengerich, Eugene J.

2008-01-01

Context: Multiple national agencies and organizations recommend that women age 40 years and older have an annual screening mammogram. Women who are poor, less educated, lack a usual source of care, and reside in rural Appalachia are less likely to have had a recent mammogram. Purpose: To increase use of mammography among a rural Appalachian…

The Potential of Solar as Alternative Energy Source for Socio-Economic Wellbeing in Rural Areas, Malaysia

NASA Astrophysics Data System (ADS)

Alam, Rashidah Zainal; Siwar, Chamhuri; Ludin, Norasikin Ahmad

Malaysia's energy sector is highly dependent on fossil fuels as a primary energy source. Economic growth and socio-economic wellbeing also rely on the utilization of energy in daily life routine. Nevertheless, the increasing cost for electricity and declining fossil fuels resources causes various negative impacts to the people and environment especially in rural areas. This prompted Malaysia to shift towards alternative energy sources such as solar energy to ensure social, economic and environmental benefits. The solar energy is one of the potential renewable energy sources in tropical countries particularly in Malaysia. The paper attempts to analyze the benefits and advantages related to energy efficiency of solar for sustainable energy use and socio economic wellbeing in rural areas, Malaysia. The paper uses secondary sources of data such as policies, regulations and research reports from relevant ministries and agencies to attain the objectives. As a signatory country to the UN Convention on Climate Change and the Kyoto Protocol, Malaysia has taken initiatives for decreasing energy dependence on oil to reduce greenhouse gas emissions (GHG) for sustainable development. The paper shows solar energy becomes one of the promising alternative energy sources to alleviate energy poverty in Malaysia for rural areas. Finally, solar energy has increased socio-economic wellbeing and develops green potential and toward achieving energy efficiency in energy sector of Malaysia by preserving environment as well as reducing carbon emission.

7 CFR 1980.346 - Other eligibility criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Other eligibility criteria. 1980.346 Section 1980.346 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED)...

7 CFR 1951.701 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Purpose. 1951.701 Section 1951.701 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) SERVICING AND...

7 CFR 1951.201 - Purposes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Purposes. 1951.201 Section 1951.201 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) SERVICING AND...

7 CFR 1962.6 - Liens and assignments on chattel property.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF..., including FSA Farm Programs (formerly ASCS) payments. (2) When a current loan is not being made to a... taken as additional security for Farm Ownership (FO), Rural Housing (RH), Labor Housing (LH), and Soil...

7 CFR 1956.139 - Collections.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 14 2011-01-01 2011-01-01 false Collections. 1956.139 Section 1956.139 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT SETTLEMENT...

7 CFR 1956.139 - Collections.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Collections. 1956.139 Section 1956.139 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT SETTLEMENT...

7 CFR 1956.139 - Collections.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 14 2013-01-01 2013-01-01 false Collections. 1956.139 Section 1956.139 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT SETTLEMENT...

7 CFR 1956.139 - Collections.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 14 2012-01-01 2012-01-01 false Collections. 1956.139 Section 1956.139 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT SETTLEMENT...

7 CFR 1956.139 - Collections.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 14 2014-01-01 2014-01-01 false Collections. 1956.139 Section 1956.139 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT SETTLEMENT...

Rural and Small Systems Guidebook to Sustainable Water and Wastewater Utility Management

EPA Pesticide Factsheets

The Guidebook is designed to introduce rural and small water and wastewater systems to the key areas of effectively managed systems. It provides background information on ten key management areas, instruction, and assistance.

77 FR 41185 - Farm, Ranch, and Rural Communities Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-12

... gives notice of a teleconference meeting of the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and recommendations... relevance for consideration by the Committee in order to provide advice and insights to the Agency on...

Rural-urban difference in the use of annual physical examination among seniors in Shandong, China: a cross-sectional study.

PubMed

Ge, Dandan; Chu, Jie; Zhou, Chengchao; Qian, Yangyang; Zhang, Li; Sun, Long

2017-05-23

Regular physical examination contributes to early detection and timely treatment, which is helpful in promoting healthy behaviors and preventing diseases. The objective of this study is to compare the annual physical examination (APE) use between rural and urban elderly in China. A total of 3,922 participants (60+) were randomly selected from three urban districts and three rural counties in Shandong Province, China, and were interviewed using a standardized questionnaire. We performed unadjusted and adjusted logistic regression models to examine the difference in the utilization of APE between rural and urban elderly. Two adjusted logistic regression models were employed to identify the factors associated with APE use in rural and urban seniors respectively. The utilization rates of APE in rural and urban elderly are 37.4% and 76.2% respectively. Factors including education level, exercise, watching TV, and number of non-communicable chronic conditions, are associated with APE use both in rural and urban elderly. Hospitalization, self-reported economic status, and health insurance are found to be significant (p < 0.05) predictors for APE use in rural elderly. Elderly covered by Urban Resident Basic Medical Insurance (URBMI) (p < 0.05, OR = 1.874) are more likely to use APE in urban areas. There is a big difference in APE utilization between rural and urban elderly. Interventions targeting identified at-risk subgroups, especially for those rural elderly, are essential to reduce such a gap. To improve health literacy might be helpful to increase the utilization rate of APE among the elderly.

7 CFR 1900.157-1900.200 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS GENERAL Processing and Servicing FmHA or Its Successor Agency Under Public Law 103-354...

7 CFR 1962.46 - Deceased borrowers.

Code of Federal Regulations, 2011 CFR

2011-01-01

...-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED... Deceased borrowers. Immediately on learning of the death of any person liable to the Agency, the County...

The association between physical medicine and rehabilitation service utilization and disability duration following work-related fracture.

PubMed

Young, Amanda; Muhlner, Stasia; Kurowski, Alicia; Cifuentes, Manuel

2015-06-05

Rural residents with work-related fractures utilize healthcare differently and return to work (RTW) sooner than their similarly-injured urban peers. To elucidate the relationship between physical medicine and rehabilitation (PM&R) service usage and work-disability duration following work-related injury. Retrospective cohort study, employing a two-phase sequential analysis. The project involved a longitudinal analysis of PM&R utilization and work-disability duration of 2,216 people across the U.S. who fractured a bone, received PM&R services, and had at least seven days off work. In the first phase of the analysis each individual was assigned a PM&R utilization score based on how similar his or her usage was to that typical of rural residents. The second phase tested the relationship between assigned PM&R utilization scores and work-disability duration. Differences in urban versus rural PM&R utilization included less total PM&R services and fewer passive services in the first 8 weeks for rural claimants. Among those off work for more than a month, rural residents used more active services just prior to RTW, with a gradual decreasing of services leading up to RTW. Controlling for covariates, aggregate PM&R utilization scores were found to relate to time to first RTW (Hazard Ratio=1.66, p<0.005). Findings suggest that using services in a way that is more consistent with rural patterns is associated with decreased work-disability durations. Consistent with previous studies, results suggest that passive services, prolonged episodes of care, and failure to focus on transitioning to self-management are related to longer work-disability durations.

Agencies Need Better Guidance for Choosing among Contracts, Grants, and Cooperative Agreements.

DTIC Science & Technology

1981-09-04

given case may require reference to a range of materials . By en- acting specific authorizing language and providing various sources to help an agency...to: --Inventory recipients’ training materials , get them well-edited, and ready for the agency’s approval, production and distribution. [service... materials to those that do. REA indicated in its Federal Register announcement that under Section 11 of the Rural Electrification Act and under the

Technology in rural transportation. Simple solution #12, public agency outreach for transportation management

DOT National Transportation Integrated Search

1997-01-01

This application was identified as a promising rural Intelligent Transportation Systems (ITS) solution under a project sponsored by the Federal Highway Administration (FHWA) and the ENTERPRISE program. This summary describes the solution as well as o...

Rural Student Vocational Program (RSVP) [and] Housing Guide for Parents and Students [and] Work Supervisor's Guide.

ERIC Educational Resources Information Center

Rural Student Vocational Program, Wasilla, AK.

The purpose of the Rural Student Vocational Program (RSVP) is to provide rural high school vocational students with work and other experiences related to their career objective. Students from outlying schools travel to Anchorage, Fairbanks, or Juneau (Alaska) to participate in two weeks of work experience with cooperating agencies and businesses.…

Diabetes education project: community networking in rural Utah.

PubMed

DeBry, S M; Smith, A; Wittenberg, M; Mortensen, V

1996-01-01

People in rural areas often lack the financial resources, workforce, and professional network needed to sustain a diabetes education pro gram in their own community. HealthInsight, a nonprofit organization that works to improve the quality of health care in its community, developed a 2-day seminar in an effort to facilitate the networking of rural health professionals who educate patients with diabetes and to help those educators better learn how to use existing resources. Participants included nurses, dietitians, diabetes educators, quality managers, and education directors from hospitals and home health agencies in both rural and metropolitan areas. Speakers presented information on a variety of topics related to program development, and a resource manual containing numerous materials was given to each participant. At the end of the seminar, the group turned in goals for their own programs. Too often, providers of health care compete rather than collaborate with one another. There is a great need for such networking opportunities among health care professionals working on common goals--especially in rural areas.

77 FR 65547 - Farm, Ranch, and Rural Communities Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

..., Public Law 92463, EPA gives notice of cancellation of that public meeting for the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC provides policy advice, information, and recommendations to the EPA... by the Committee in order to provide advice and insights to the Agency on environmental policies and...

Summer programming in rural communities: unique challenges.

PubMed

Phillips, Ruthellen; Harper, Stacey; Gamble, Susan

2007-01-01

During the past several decades, child poverty rates have been higher in rural than in urban areas, and now 2.5 million children live in deep poverty in rural America. Studies indicate that poor children are most affected by the typical "summer slide." Summer programming has the ability to address the issues of academic loss, nutritional loss, and the lack of safe and constructive enrichment activities. However, poor rural communities face three major challenges in implementing summer programming: community resources, human capital, and accessibility. The success of Energy Express, a statewide award-winning six-week summer reading and nutrition program in West Virginia, documents strategies for overcoming the challenges faced by poor, rural communities in providing summer programs. Energy Express (1) uses community collaboration to augment resources and develop community ownership, (2) builds human capital and reverses the acknowledged brain drain by engaging college students and community volunteers in meaningful service, and (3) increases accessibility through creative transportation strategies. West Virginia University Extension Service, the outreach arm of the land-grant institution, partners with AmeriCorps, a national service program, and various state and local agencies and organizations to implement a program that produces robust results.

7 CFR Appendix - Exhibits to Subpart E of Part 1951

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 14 2012-01-01 2012-01-01 false Exhibits to Subpart E of Part 1951 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) SERVICING AND...

7 CFR Appendix - Exhibits to Subpart E of Part 1951

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 14 2011-01-01 2011-01-01 false Exhibits to Subpart E of Part 1951 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) SERVICING AND...

7 CFR Appendix - Exhibits to Subpart E of Part 1951

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 14 2013-01-01 2013-01-01 false Exhibits to Subpart E of Part 1951 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) SERVICING AND...

7 CFR 1956.85 - Payments and receipts.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 14 2013-01-01 2013-01-01 false Payments and receipts. 1956.85 Section 1956.85 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT...

7 CFR 1951.10 - Application of payments on production type loan accounts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 14 2011-01-01 2011-01-01 false Application of payments on production type loan accounts. 1951.10 Section 1951.10 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED)...

7 CFR 1951.10 - Application of payments on production type loan accounts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Application of payments on production type loan accounts. 1951.10 Section 1951.10 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED)...

7 CFR 1956.85 - Payments and receipts.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 14 2012-01-01 2012-01-01 false Payments and receipts. 1956.85 Section 1956.85 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT...

7 CFR 1956.85 - Payments and receipts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Payments and receipts. 1956.85 Section 1956.85 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT...

7 CFR 1951.10 - Application of payments on production type loan accounts.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 14 2012-01-01 2012-01-01 false Application of payments on production type loan accounts. 1951.10 Section 1951.10 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED)...

7 CFR 1951.10 - Application of payments on production type loan accounts.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 14 2014-01-01 2014-01-01 false Application of payments on production type loan accounts. 1951.10 Section 1951.10 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED)...

7 CFR 1951.10 - Application of payments on production type loan accounts.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 14 2013-01-01 2013-01-01 false Application of payments on production type loan accounts. 1951.10 Section 1951.10 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED)...

7 CFR 1956.85 - Payments and receipts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 14 2011-01-01 2011-01-01 false Payments and receipts. 1956.85 Section 1956.85 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT...

7 CFR 1956.85 - Payments and receipts.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 14 2014-01-01 2014-01-01 false Payments and receipts. 1956.85 Section 1956.85 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) DEBT...

Pragmatic prevention, permanent solution: Women's experiences with hysterectomy in rural India.

PubMed

Desai, Sapna

2016-02-01

Hysterectomy appears to be on the rise amongst low-income, rural women in India as routine treatment for gynaecological ailments. This paper explores the individual, household, socio-economic and health system factors that influenced women's decisions to undergo hysterectomy in rural Gujarat, with a focus on women's perspectives. Interviews were conducted with 35 rural, low-income women who had undergone hysterectomy, local gynaecologists and other key informants, alongside observation of daily life and health-related activities. Inductive, open coding was conducted within a framework analysis to identify thematic influences on the decision to undergo hysterectomy. Women underwent hysterectomy at an average age of 36, as treatment for typically severe gynaecological ailments. I argue that women, faced with embedded social inequality in the form of gender biases, lack of labour security and a maternal-centric health system, demonstrated pragmatic agency in their decision to remove the uterus. When they experienced gynaecological ailments, most sought two to three opinions and negotiated financial and logistical concerns. The health system offered few non-invasive services for non-maternal health issues. Moreover, women and health care providers believed there is limited utility of the uterus beyond childbearing. Women's responsibilities as caretakers, workers and producers drove them to seek permanent solutions that would secure their long-term work and health security. Thus, hysterectomy emerged as a normalised treatment for gynaecological ailments, particularly for low-income women with limited resources or awareness of potential side effects. In this setting, hysterectomy reflects the power structures and social inequalities in which women negotiated medical treatment--and the need to reverse a culture of permanent solutions for low-income women. Copyright © 2016 Elsevier Ltd. All rights reserved.

Patterns and determinants of small-quantity LNS utilization in rural Malawi and Mozambique: considerations for interventions with specialized nutritious foods.

PubMed

Kodish, Stephen R; Aburto, Nancy J; Nseluke Hambayi, Mutinta; Dibari, Filippo; Gittelsohn, Joel

2017-01-01

Small-quantity, lipid-based nutrient supplements (SQ-LNS) show promise to improve the quality of maternal and child diets, particularly during the first 1000 days of life. The potential of SQ-LNS to impact positively upon nutritional status relies on numerous factors, including complementary dietary intake, disease prevalence and dynamics of household utilization, including sharing practices. Therefore, this study sought to elucidate the patterns and determinants of SQ-LNS utilization among children 6-23 months and potential sharing practices of other household members prior to intervention development. In Ntchisi, Malawi and Cabo Delgado, Mozambique, both rural, agricultural settings, we conducted two home-feeding trials of 8 and 6 weeks, respectively, nested within a larger multi-phase, emergent formative research design. Multiple methods, including in-depth interviews (n = 38), direct meal observations (n = 80), full-day child observations (n = 38) and spot checks of SQ-LNS supply (n = 23), were conducted with households (n = 35 in Malawi; n = 24 in Mozambique). Overall, the SQ-LNS was utilized contrary to its recommended use, with 50% of households in Malawi reporting running out of stock too early and 87% of households in Mozambique either overusing or underusing the product. Utilization of SQ-LNS was manifested in four patterns of overuse and two of underuse and was determined by factors at multiple levels of influence. Maternal and child health efforts need to consider the reasons behind choices by households to overuse or underuse SQ-LNS and design intervention strategies to increase the likelihood of its appropriate utilization. © 2016 John Wiley & Sons Ltd.

75 FR 81327 - Agency Information Collection Activity Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

... urban and rural transportation. 49 U.S.C. 5303 and 5304 and 23 U.S.C. 134 and 135 authorize the use of... DEPARTMENT OF TRANSPORTATION Federal Transit Administration [FTA Docket No. FTA-2010-0048] Agency... collection: Metropolitan and Statewide Transportation Planning. The information collected for this program is...

The South Carolina rural-urban HIV continuum of care.

PubMed

Edun, Babatunde; Iyer, Medha; Albrecht, Helmut; Weissman, Sharon

2017-07-01

The HIV continuum of care model is widely used by various agencies to describe the HIV epidemic in stages from diagnosis through to virologic suppression. It identifies the various points at which persons living with HIV (PLWHIV) within a population fail to reach their next step in HIV care. The rural population in the Southern United States is disproportionally affected by the HIV epidemic. The purpose of this study was to examine these rural-urban disparities using the HIV care continuum model and determine at what stages these differences become apparent. PLWHIV aged 13 years and older in South Carolina (SC) were identified using data from the enhanced HIV/AIDS Reporting System. The percentages of PLWHIV linked to care, retained in care, and virologically suppressed were determined. Rural versus urban residence was determined using the Office of Management and Budget classification. There were 14,523 PLWHIV in SC at the end of 2012; 11,193 (77%) of whom were categorized as urban and 3305 (22%) as rural. There was no difference between urban and rural for those who had received any care: 64% versus 64% (p = .61); retention in care 53% versus 53% (p = .71); and virologic suppression 49% versus 48% (p = .35), respectively. The SC rural-urban HIV cascade represents the first published cascade of care model using rural versus urban residence. Although significant health care disparities exist between rural and urban residents, there were no major differences between rural and urban residents at the various stages of engagement in HIV care using the HIV continuum of care model.

78 FR 8353 - Rural Broadband Access Loans and Loan Guarantees

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

.... Other associated rural issues, such as environmental challenges or providing wireless service through... proposed regulations, the Food, Conservation, and Energy Act of 2008, more commonly known as the 2008 Farm... wireline and wireless technologies is in violation of the agency's ``technology neutral'' mandate and...

77 FR 7576 - Farm, Ranch, and Rural Communities Committee (FRRCC)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

..., Ranch, and Rural Communities Committee (FRRCC). SUMMARY: The U.S. Environmental Protection Agency (EPA... approved by the Designated Federal Officer (DFO). Meetings will generally be held in Washington, DC... diverse candidates, EPA encourages nominations of women and men of all racial and ethnic groups. In...

Developing rural palliative care: validating a conceptual model.

PubMed

Kelley, Mary Lou; Williams, Allison; DeMiglio, Lily; Mettam, Hilary

2011-01-01

The purpose of this research was to validate a conceptual model for developing palliative care in rural communities. This model articulates how local rural healthcare providers develop palliative care services according to four sequential phases. The model has roots in concepts of community capacity development, evolves from collaborative, generalist rural practice, and utilizes existing health services infrastructure. It addresses how rural providers manage challenges, specifically those related to: lack of resources, minimal community understanding of palliative care, health professionals' resistance, the bureaucracy of the health system, and the obstacles of providing services in rural environments. Seven semi-structured focus groups were conducted with interdisciplinary health providers in 7 rural communities in two Canadian provinces. Using a constant comparative analysis approach, focus group data were analyzed by examining participants' statements in relation to the model and comparing emerging themes in the development of rural palliative care to the elements of the model. The data validated the conceptual model as the model was able to theoretically predict and explain the experiences of the 7 rural communities that participated in the study. New emerging themes from the data elaborated existing elements in the model and informed the requirement for minor revisions. The model was validated and slightly revised, as suggested by the data. The model was confirmed as being a useful theoretical tool for conceptualizing the development of rural palliative care that is applicable in diverse rural communities.

Health care utilization and outpatient, out-of-pocket costs for active convulsive epilepsy in rural northeastern South Africa: a cross-sectional Survey.

PubMed

Wagner, Ryan G; Bertram, Melanie Y; Gómez-Olivé, F Xavier; Tollman, Stephen M; Lindholm, Lars; Newton, Charles R; Hofman, Karen J

2016-06-28

Epilepsy is a common neurological disorder, with over 80 % of cases found in low- and middle-income countries (LMICs). Studies from high-income countries find a significant economic burden associated with epilepsy, yet few studies from LMICs, where out-of-pocket costs for general healthcare can be substantial, have assessed out-of-pocket costs and health care utilization for outpatient epilepsy care. Within an established health and socio-demographic surveillance system in rural South Africa, a questionnaire to assess self-reported health care utilization and time spent traveling to and waiting to be seen at health facilities was administered to 250 individuals, previously diagnosed with active convulsive epilepsy. Epilepsy patients' out-of-pocket, medical and non-medical costs and frequency of outpatient care visits during the previous 12-months were determined. Within the last year, 132 (53 %) individuals reported consulting at a clinic, 162 (65 %) at a hospital and 34 (14 %) with traditional healers for epilepsy care. Sixty-seven percent of individuals reported previously consulting with both biomedical caregivers and traditional healers. Direct outpatient, median costs per visit varied significantly (p < 0.001) between hospital (2010 International dollar ($) 9.08; IQR: $6.41-$12.83) and clinic consultations ($1.74; IQR: $0-$5.58). Traditional healer fees per visit were found to cost $52.36 (IQR: $34.90-$87.26) per visit. Average annual outpatient, clinic and hospital out-of-pocket costs totaled $58.41. Traveling to and from and waiting to be seen by the caregiver at the hospital took significantly longer than at the clinic. Rural South Africans with epilepsy consult with both biomedical caregivers and traditional healers for both epilepsy and non-epilepsy care. Traditional healers were the most expensive mode of care, though utilized less often. While higher out-of-pocket costs were incurred at hospital visits, more people with ACE visited hospitals

The rural nurse work environment and structural empowerment.

PubMed

Krebs, Julianne P; Madigan, Elizabeth A; Tullai-McGuinness, Susan

2008-02-01

Rural health care organizations struggle to attract and retain nurses, yet much of the research has focused on characteristics of the nurse work environment or empowerment in urban hospitals. The purpose of this study was to examine the nurse work environment in rural areas across settings by describing the relationship between structural empowerment and characteristics of the nurse work environment. Nurses ( N = 97) working in home care agencies and hospitals were surveyed. Significant differences were found between the groups, with home care nurses having significantly higher empowerment scores than medical/surgical nurses. A strong correlation was found between characteristics of the nurse work environment and empowerment. Policy makers are using evidence to guide development of policies, but much of the research has been conducted in urban hospital settings. This study begins to provide evidence that differences exist between urban and rural areas and between practice settings.

Evaluation of low cost traffic calming for rural communities : phase II.

DOT National Transportation Integrated Search

2013-04-01

The main goal of the research described in this report was to evaluate countermeasures that agencies can use to reduce speeds as drivers enter rural communities located on high-speed roadways. The objectives of this study were as follows: : Identify ...

7 CFR 1940.321 - Use of completed EIS.

Code of Federal Regulations, 2010 CFR

2010-01-01

... final EIS will be a major factor in the Agency's final decision. Agency staff making recommendations on...-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED... subpart and provide them to the approving official prior to a final decision. ...

Agency Theory, Incentives, and Student Loans.

ERIC Educational Resources Information Center

Rudner, Lawrence M.

Using agency theory, this paper analyzes schools, particularly career schools, in the Stafford Loan Program for student incentive to graduate and pay off their loans. Agency theory focuses on the roles of information and incentives when a principal and an agent cooperate with respect to the utilization of resources. The analysis examines the…

7 CFR 1940.313 - Actions that normally require the preparation of an Environmental Impact Statement (EIS).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Actions that normally require the preparation of an Environmental Impact Statement (EIS). 1940.313 Section 1940.313 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMEN...

7 CFR 1951.890 - Office of Inspector General and Office of General Counsel referrals.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Office of Inspector General and Office of General Counsel referrals. 1951.890 Section 1951.890 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE ...

Building a sustainable workforce in a rural and remote health service: A comprehensive and innovative Rural Generalist training approach.

PubMed

Orda, Ulrich; Orda, Sabine; Sen Gupta, Tarun; Knight, Sabina

2017-04-01

Historically it has been challenging to recruit and retain an appropriately trained medical workforce to care for rural and remote Australians. This paper describes the Queensland North West Hospital and Health Service (NWHHS) workforce redesign, developing education strategies and pathways to practice, thereby improving service provision, recruitment and retention of staff. The Mount Isa-based Medical Education Unit sought accreditation for a Rural Generalist (RG) training pathway from Internship to Fellowship with the Australian College of Rural and Remote Medicine (ACRRM) and the Regional Training Provider (RTP). This approach enhanced the James Cook University (JCU) undergraduate pathway for rurally committed students while improving recruitment and retention of RMOs/Registrars. Accreditation was achieved through collaboration with training providers, accreditation agencies, ACRRM and a local general practice. The whole pathway from ignore Internship to Fellowship is offered with the RG Intern intake as a primary allocation site beginning in 2016. Comprehensive supervision and excellent clinical exposure provide an interesting and rewarding experience - for staff at all levels. Since 2013 RMO locum rates have been <1%. Registrars on the ACRRM pathway and Interns increased from 0 to 7 positions each in 2015, with similar achievements in SMO staffing. Three RMOs expressed interest in a Registrar position, CONCLUSIONS: Appropriate governance is needed to develop and advertise the program. This includes the NWHHS, the RG Pathway and JCU. © 2016 National Rural Health Alliance Inc.

Rural access to clinical pharmacy services.

PubMed

Patterson, Brandon J; Kaboli, Peter J; Tubbs, Traviss; Alexander, Bruce; Lund, Brian C

2014-01-01

To examine the impact of rural residence and primary care site on use of clinical pharmacy services (CPS) and to describe the use of clinical telepharmacy within the Veterans Health Administration (VHA) health care system. Using 2011 national VHA data, the frequency of patients with CPS encounters was compared across patient residence (urban or rural) and principal site of primary care (medical center, urban clinic, or rural clinic). The likelihood of CPS utilization was estimated with random effects logistic regression. Individual service types (e.g., anticoagulation clinics) and delivery modes (e.g., telehealth) were also examined. Of 3,040,635 patients, 711,348 (23.4%) received CPS. Service use varied by patient residence (urban: 24.9%; rural: 19.7%) and principal site of primary care (medical center: 25.9%; urban clinic: 22.5%; rural clinic: 17.6%). However, in adjusted analyses, urban-rural differences were explained primarily by primary care site and less so by patient residence. Similar findings were observed for individual CPS types. Telehealth encounters were common, accounting for nearly one-half of patients receiving CPS. Video telehealth was infrequent (<0.2%), but more common among patients of rural clinics than those receiving CPS at medical centers (odds ratio [OR] = 9.7; 95% CI 9.0-10.5). We identified a potential disparity between rural and urban patients' access to CPS, which was largely explained by greater reliance on community clinics for primary care than on medical centers. Future research is needed to determine if this disparity will be alleviated by emerging organizational changes, including expanding telehealth capacity and integrating pharmacists into primary care teams, and whether lessons learned at VHA translate to other settings.

7 CFR 4280.15 - Ultimate Recipient Projects eligible for Rural Economic Development Loan funding.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF... may only be used to provide the following assistance: (a) Start-Up Venture costs, including, but not... capital; (b) Business expansion; (c) Business Incubators; (d) Technical Assistance; (e) Project...

Utility Energy Services Contracts: Enabling Documents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, Karen; Vasquez, Deb

The Federal Energy Management Program's 'Utility Energy Service Contracts: Enabling Documents' provide legislative information and materials that clarify the authority for federal agencies to enter into utility energy service contracts, or UESCs.

41 CFR 102-75.85 - Can disposal agencies transfer excess real property to agencies for programs that appear to be...

Code of Federal Regulations, 2011 CFR

2011-01-01

... further Federal utilization or disposal as surplus property at an agreed upon time when the transfer is... PROPERTY DISPOSAL Utilization of Excess Real Property Guidelines § 102-75.85 Can disposal agencies transfer...

The Yellow Pages for Rural Development in New Mexico.

ERIC Educational Resources Information Center

Pino, Ricardo, Comp.

Designed to inform the public of rural development programs and services in the State of New Mexico, this directory presents over 100 program summaries, providing mailing addresses and telephone numbers and naming the agency, the specific program thrust, the Officer in Charge, and other contacts. Both an alphabetical and functional index are…

Guidebook : managing operating costs for rural and small urban public transit systems.

DOT National Transportation Integrated Search

2013-05-01

This guidebook is a resource for rural and small urban transit agency managers to use in better understanding, predicting, and managing operational costs. Doing so can improve the efficiency, effectiveness, and sustainability of public transit in the...

Rural versus Suburban Primary Care Needs, Utilization, and Satisfaction with Telepsychiatric Consultation

ERIC Educational Resources Information Center

Hilty, Donald M.; Nesbitt, Thomas S.; Kuenneth, Christina A.; Cruz, Grace M.; Hales, Robert E.

2007-01-01

Context and Purpose: Rural and suburban populations remain underserved in terms of psychiatric services but have not been compared directly in terms of using telepsychiatry. Methods: Patient demographics, reasons for consultation, diagnosis, and alternatives to telepsychiatric consultation were collected for 200 consecutive, first-time…

7 CFR 2003.26 - Functional organization of RBS.

Code of Federal Regulations, 2012 CFR

2012-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... loans and technical assistance to businesses and communities for rural citizens and cooperatives..., contracting, automated information systems, and accounting. The staff provides analysis and recommendations on...

7 CFR 2003.26 - Functional organization of RBS.

Code of Federal Regulations, 2013 CFR

2013-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... loans and technical assistance to businesses and communities for rural citizens and cooperatives..., contracting, automated information systems, and accounting. The staff provides analysis and recommendations on...

7 CFR 2003.26 - Functional organization of RBS.

Code of Federal Regulations, 2014 CFR

2014-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... loans and technical assistance to businesses and communities for rural citizens and cooperatives..., contracting, automated information systems, and accounting. The staff provides analysis and recommendations on...

Workshop in a Box: Sustainable Management of Rural and Small Water and Wastewater Systems Workshops

EPA Pesticide Factsheets

A resource to help rural and small systems and communities to conduct workshops, either for an individual system or for a group of systems, based on the Rural and Small Systems Guidebook to Sustainable Utility Management.

Comparison and Research on New Rural Community Management Patterns of Shan Dong Province

NASA Astrophysics Data System (ADS)

Fang, Lei; Zhang, Xiaomei

Rural community is an important institutional innovation,which has important effect and edification to future new rural management.There are three new rural community management patterns in shandong province:divisions of the village community,many villages community and village merge community. This article not only introduce three models,but also compare them in four aspects: community scale, community management,infrastructure,resource utilization.Pointing out the strength and weakness of three models.Drawing a conclusion that village merge community is the active reaction for rural urbanization. And could be the important recommended breed.

Information for a Rural Community: The South Molton Community Information Project. Library and Information Research Report 40.

ERIC Educational Resources Information Center

Venner, David G.; Cotton, Sally

Of potential interest to small towns in rural areas, this report describes England's first attempt at applying to a rural area the concept of a multi-agency information and advice center based on a library. The comprehensive review covers all phases of the project: (1) identification of a community's information and advice needs; (2) consultation…

Thermal Standard for Small Rural Schools.

ERIC Educational Resources Information Center

Strandberg (J.S.) Consulting Engineering, Fairbanks, AK.

The Standard's purpose is to provide design requirements that will improve energy utilization in new State of Alaska owned rural educational facilities ranging in size from 7,000 to 12,000 square feet. The Standard covers exterior envelopes and selection of heating, ventilating and air conditioning systems, service water systems, energy…

Prevalence of pediatric epilepsy in low-income rural Midwestern counties.

PubMed

Hawley, Suzanne R; Ablah, Elizabeth; Hesdorffer, Dale; Pellock, John M; Lindeman, David P; Paschal, Angelia M; Thurman, David J; Liu, Yi; Warren, Mary Beth; Schmitz, Terri; Rogers, Austin; St Romain, Theresa; Hauser, W Allen

2015-12-01

Epilepsy is one of the most common disabling neurological disorders, but significant gaps exist in our knowledge about childhood epilepsy in rural populations. The present study assessed the prevalence of pediatric epilepsy in nine low-income rural counties in the Midwestern United States overall and by gender, age, etiology, seizure type, and syndrome. Multiple sources of case identification were used, including medical records, schools, community agencies, and family interviews. The prevalence of active epilepsy was 5.0/1000. Prevalence was 5.1/1000 in males and 5.0/1000 in females. Differences by age group and gender were not statistically significant. Future research should focus on methods of increasing study participation in rural communities, particularly those in which research studies are rare. Copyright © 2015 Elsevier Inc. All rights reserved.

Urban-rural mining: waste utilization in Guangdong, China

NASA Astrophysics Data System (ADS)

Zhao, D. D.; Huhetaoli; Yuan, H. R.; Tang, Z. H.

2018-05-01

Attitudes towards waste have changed gradually in view of the environmental pollution created and the potential of waste as a resource. This has led to the city and countryside of China being viewed as a complete "urban-rural mine" resources are extracted from what was once considered waste. Guangdong is a developed province and annual waste generation has recently exceeded 300 million tons. The waste distribution characteristics are as follows: most industrial solid waste is produced in the Pearl River Delta and Mountainous Region, waste associated with domestic activities is concentrated in the Pearl River Delta, and agricultural waste is found throughout the province. The ratios of material recycling and energy recovery are 58% and 11%, respectively, of collected waste. Recycled products include construction material, artificial boards, fuel, plastic, metal, chemicals, oil, and fibers. Energy is recovered by generating electricity from domestic waste, landfill gas, and forest and crop residue.

A telecommunications journey rural health network.

PubMed

Moore, Joe

2012-01-01

Utilizing a multi-gigabit statewide fiber healthcare network, Radiology Consultants of Iowa (RCI) set out to provide instantaneous service to their rural, critical access, hospital partners. RCIs idea was to assemble a collection of technologies and services that would even out workflow, reduce time on the road, and provide superior service. These technologies included PACS, voice recognition enabled dictation, HL7 interface technology, an imaging system for digitizing paper and prior films, and modern communication networks. The Iowa Rural Health Telecommunication Project was undertaken to form a system that all critical access hospitals would participate in, allowing RCI radiologists the efficiency of "any image, anywhere, anytime".

Identification of differences between rural and urban safety cultures.

PubMed

Rakauskas, Michael E; Ward, Nicholas J; Gerberich, Susan G

2009-09-01

The prevailing risk of traffic fatalities is much larger in rural areas compared to urban areas. A number of explanations have been offered to explain this including road design, emergency medical service proximity, and human factors. This research explored the potential contribution of rural driver attitudes that may underlie the increased fatal crash risk in rural environments. This analysis examined differences between rural and urban drivers in terms of self-reported risk taking for driving behaviors associated with fatal crashes and attitudes toward safety interventions using a large-scale survey. The results suggested that rural drivers engage in riskier behavior, such as not wearing seatbelts, because they have lower perceptions of the risks associated with such behaviors. Results also suggested that vehicle type (e.g., pickup trucks versus passenger vehicles) may be related to seatbelt compliance and frequency of driving under the influence of alcohol. Rural drivers perceived the utility of government-sponsored traffic safety interventions to be lower than their urban counterparts. This study provides insights into the role of the human factor in rural fatal crashes and provides policy suggestions for developing safety interventions that are designed with respect to the psychosocial factors that define the rural culture.

7 CFR 1955.111 - Sale of real estate for RH purposes (housing).

Code of Federal Regulations, 2010 CFR

2010-01-01

... HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) PROPERTY MANAGEMENT Disposal of... Housing Act of 1949, as amended, (RH property). Single family units (generally which secured loans made...

7 CFR 4287.124 - Alterations of loan instruments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4287.124 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE SERVICING Servicing Business and... approve any alterations of any loan instrument without the prior written approval of the Agency. ...

7 CFR 1980.318 - Flood or mudslide hazard area precautions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... dwelling location and construction plans and specifications for new buildings or improvements to existing... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... there is no practical alternative. (a) Dwelling location. Dwellings and building improvements located in...

7 CFR 4287.107 - Routine servicing.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE SERVICING Servicing Business and Industry Guaranteed... provide the Agency with a written summary of the lender's analysis and conclusions, including trends...

7 CFR 4287.107 - Routine servicing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE SERVICING Servicing Business and Industry Guaranteed... provide the Agency with a written summary of the lender's analysis and conclusions, including trends...

41 CFR 102-75.85 - Can disposal agencies transfer excess real property to agencies for programs that appear to be...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 75-REAL PROPERTY DISPOSAL Utilization of Excess Real Property Guidelines § 102-75.85 Can disposal agencies transfer... transfer excess real property to agencies for programs that appear to be scheduled for substantial...

A Systematic Review of Rural, Theory-based Physical Activity Interventions.

PubMed

Walsh, Shana M; Meyer, M Renée Umstattd; Gamble, Abigail; Patterson, Megan S; Moore, Justin B

2017-05-01

This systematic review synthesized the scientific literature on theory-based physical activity (PA) interventions in rural populations. PubMed, PsycINFO, and Web of Science databases were searched to identify studies with a rural study sample, PA as a primary outcome, use of a behavioral theory or model, randomized or quasi-experimental research design, and application at the primary and/or secondary level of prevention. Thirty-one studies met our inclusion criteria. The Social Cognitive Theory (N = 14) and Transtheoretical Model (N = 10) were the most frequently identified theories; however, most intervention studies were informed by theory but lacked higher-level theoretical application and testing. Interventions largely took place in schools (N = 10) and with female-only samples (N = 8). Findings demonstrated that theory-based PA interventions are mostly successful at increasing PA in rural populations but require improvement. Future studies should incorporate higher levels of theoretical application, and should explore adapting or developing rural-specific theories. Study designs should employ more rigorous research methods to decrease bias and increase validity of findings. Follow-up assessments to determine behavioral maintenance and/or intervention sustainability are warranted. Finally, funding agencies and journals are encouraged to adopt rural-urban commuting area codes as the standard for defining rural.

75 FR 14183 - Office of Community Oriented Policing Services; Agency Information Collection Activities...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... DEPARTMENT OF JUSTICE [OMB Number 1103-NEW] Office of Community Oriented Policing Services; Agency Information Collection Activities: Proposed Collection; Comments Requested ACTION: 60-day notice of information collection under review: COPS' Rural Law Enforcement National Training Assessment. The Department...

Rural brewing, exclusion, and development policy-making.

PubMed

Mccall, M

1996-10-01

This article highlights the economic role of women in the brewing industry in rural and periurban areas of sub-Saharan African countries. Local beer drinking is a form of social exchange and a reward for time-intensive work. Modern beer brewing in rural areas is a family operation. Beer is produced for subsistence and for sale. Locally brewed beer has a lower alcohol content than commercial brews. The author refers to Pradervand's (1990) study of local brewing in five east and west African countries. Pradervand found that men spent an estimated CFAF 18 billion per year on local brews compared to the value of total national exports of CFAF 21 billion per year in 1996. The male Kitui in rural Kenya were found to spend 60% of their weekly income on beer. Women dominate brewing in eastern and southern Africa. Rural beers are grain based (maize, millet, or sorghum), but may also be made from bananas, bamboo, sugar cane, or coconut. An estimated 25% of women in a village survey in Tanzania reported that beer was brewed one to four times a month. Another survey in the 1980s found that 73% of women brewed beer at some time. Beer brewing is a very significant economic activity for rural women. It provides higher levels of income and employment. Urban brewing by women has a negative image that rural women's beer brewing does not have. Grain for brewing comes from family farms or markets. Women's clubs are used as income generation groups for loans and as support groups. Women's beer brewing is not supported by development interventions or recognized by UN agencies. There are resource implications due to an estimated 5%-30% of annual wood consumption used for beer brewing. If women's role in beer brewing is ignored, male-dominated commercial interests will further marginalize rural women.

Development of a Rural Health Framework: Implications for Program Service Planning and Delivery

PubMed Central

White, Deanna

2013-01-01

Purpose: To describe the development and application of an evidence-based Rural Health Framework to guide rural health program, policy and service planning. Methods: A literature review of rural health programs, focusing on health promotion, chronic disease prevention and population health, was conducted using several bibliographic databases. Findings: Thirty papers met the criteria for review, describing chronic disease interventions and public health policies in rural settings. Twenty-one papers demonstrated effective intervention programs and highlighted potential good practices for rural health programs, which were used to define key elements of a Rural Health Framework. Conclusions: The Rural Health Framework was applied to an influenza immunization program to demonstrate its utility in assisting public health providers to increase uptake of the vaccine. This Rural Health Framework provides an opportunity for program planners to reflect on the key issues facing rural communities to ensure the development of policies and strategies that will prudently and effectively meet population health needs. PMID:23968625

The Federal Role in Rural Graduate Medical Education Initiatives. Commentary.

ERIC Educational Resources Information Center

Myers, Wayne W.

2000-01-01

Two views within the federal government regarding funding medical education--"just send money" and "prudent purchaser"--and their implications for rural America are discussed in the context of budget shifts toward pediatric training and National Institute of Health programs, different agency mandates, the high cost of health care and medical…

76 FR 34839 - Establishment of the White House Rural Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... of America and in order to enhance Federal engagement with rural communities, it is hereby ordered as... Quality; (24) the White House Office of Public Engagement and Intergovernmental Affairs; (25) the White... part of the member's department, agency, or office, and who is a full-time officer or employee of the...

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA.

PubMed

Smith, Matthew Lee; Prohaska, Thomas R; MacLeod, Kara E; Ory, Marcia G; Eisenstein, Amy R; Ragland, David R; Irmiter, Cheryl; Towne, Samuel D; Satariano, William A

2017-02-10

Background : Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods : Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results : Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions : Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients.

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA

PubMed Central

Smith, Matthew Lee; Prohaska, Thomas R.; MacLeod, Kara E.; Ory, Marcia G.; Eisenstein, Amy R.; Ragland, David R.; Irmiter, Cheryl; Towne, Samuel D.; Satariano, William A.

2017-01-01

Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions: Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients. PMID:28208610